Yes, Medicare often covers pelvic floor physical therapy, but certain conditions must be met. Let’s explore what that means & how you can prepare.
What Does Medicare Typically Cover?
Under Medicare Part B, outpatient physical therapy including pelvic floor therapy is usually covered when it is medically necessary. That means your doctor or qualified provider must first evaluate your condition & issue a formal referral for therapy.
To qualify for coverage…
-
A healthcare provider must refer you for treatment.
-
The therapy must be clinically appropriate based on your diagnosis.
-
A licensed physical therapist must deliver or supervise the care.
-
Services must be provided at a Medicare-certified facility.
Once these requirements are met, Medicare may cover services such as…
-
Initial evaluations & personalized care plans
-
Internal or external pelvic floor muscle therapy
-
Manual therapy for muscle release
-
Functional training for bladder, bowel, & core coordination
-
Home exercise instruction & self-care education
After your deductible is met, Medicare typically covers 80% of the approved therapy cost, & you’re responsible for the remaining 20% unless you have supplemental coverage.
Do Medicare Advantage Plans Cover Pelvic Floor Therapy?
While traditional Medicare often provides direct coverage, Medicare Advantage (Part C) plans can differ. These private plans may require…
-
Prior authorization for therapy
-
That you use in-network providers
-
A specific number of visits within a calendar year
Before starting therapy, it’s wise to contact your insurance provider to confirm your benefits and determine if any restrictions apply.
At Physical Therapy by Phoenix in Springfield, MO, we aim to make your experience as stress-free as possible. From your first phone call, our friendly team works with your doctor to gather referrals, verify insurance benefits, & explain your coverage clearly, so there are no unexpected costs or delays.
We specialize in helping patients covered by Medicare regain strength, reduce pain, & improve their quality of life through targeted pelvic floor therapy.
Let’s Get Started
If you’re ready to explore pelvic floor physical therapy or still have questions about your Medicare coverage our team is here to guide you every step of the way.
Address – 1839 E. Independence, Ste R, Springfield, MO 65804
Phone – (417) 708-5174
Website – https://ptphoenixspringfield.com
