Medicare Part B (medical insurance) helps pay for medically necessary outpatient physical and occupational therapy, and speech-language pathology services. In 2018, limits were eliminated on how much Medicare pays for therapy services in one calendar year.
However, if your therapy claims reach certain amounts set by Medicare, your therapy provider will need to add notations to your therapy claims and medical record to indicated that the therapy is reasonable and necessary and why the services are needed.
Your therapy provider must provide you an Advance Beneficiary Notice of Noncoverage when offering services that are not medically necessary. This allows you to decide whether you want the services, which you will be responsible for paying.