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Medical Forum / Diseases and Disorders / Arthritis / April 2008

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Physical Therapy $ limit

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sweetpickleNO@SPAMknology.net - 22 Apr 2008 18:03 GMT
As of Feb. 13, 2008. my Medicare statement says-- Coverage by Medicare is
limited to $1,1810 (maybe they meant $1,181) in 2008 for outpatient physical
therapy and speech-language pathology combined.  Medicare pays up to 80% of
the limits after the deductible has been met.  Exceptions to these limits
apply to therapy billed by hospital outpatient departments and may also
apply to medically necessary services.
Gwen
Nann Bell - 24 Apr 2008 14:04 GMT
> As of Feb. 13, 2008. my Medicare statement says-- Coverage by Medicare is
> limited to $1,1810 (maybe they meant $1,181) in 2008 for outpatient physical
[quoted text clipped - 3 lines]
> apply to medically necessary services.
> Gwen

Your post got me wondering and I went googling.  It looks like the limit is
$1.810 for outpatient therapy that is not medically necessary.  So "not
medically necessary" PT at a hospital center is covered?  And who determines
"medically necessary"?  And since when is it less costly to require folks to
go to a hospital based center for PT?  That's just nuts.  They are being
penny wise and pound foolish IMO.

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