Reduce Medicare Costs with Physical Therapy

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physical therapy medicare costs

A new study by The Moran Company shows that Medicare patients recently diagnosed with lower back pain who received physical therapy as their first treatment lowered their health insurance costs and improved their physical function when compared to receiving injections or surgery as the first intervention. With 80% of the U.S. adult population experiencing lower back pain, these findings could make a big difference in the way we view healthcare coverage.

How Physical Therapy Can Prevent Extra Medical Costs

Keeping active can reduce pain and keep you healthier throughout your life. Physical therapy and other forms of exercise are very important for the prevention of disease and injury. Physical therapy is used to treat several ailments, including falls, osteoporosis, arthritis, Parkinson’s, stroke, dementia, incontinence, and balance problems. Simply building strength and flexibility is key to being able to get around, keep fit, and prevent decline.

According to Physical Therapy Assistant and Therapy Case Reviewer Carrie Lewis of myNEXUS, many people compensate after hip or knee replacements by sitting or walking differently, causing their alignment to be off and resulting in lower back pain. “Addressing the issue early on with easy leg and back stretches could have prevented the lower back pain,” she says.  “Also core strengthening and stabilization, and lower extremity strengthening are important. It’s all connected.”

Lewis cites inactivity and education as two of the key issues with older patients. People tend to become more sedentary as they age, and also there is time involved in educating seniors on stretching, as flexibility wasn’t recognized as important as it is today when they were growing up.

“Staying active is huge in avoiding back pain,” Lewis reiterates. “Anything as simple as a daily walk or stretching can help with that. Surgery, injection, and medicine are always things you would like to avoid, so that is why exercise and strengthening are so beneficial.”

With falls being such a common occurrence in the elderly, and one of the major precursors to physical therapy, the Center for Disease Control offers some advice for preventing falls, such as taking Vitamin D, removing obstacles in your home, and having your eyes checked.

In addition to seeking physical therapy, the part-b offers some simple back stretches to ease lower back pain and eliminate the need for surgery. A little bit of movement now could save a lot of pain and cost later.

Physical Therapy Coverage Under Medicare

So what amount of physical therapy is actually covered by Medicare? Medicare Part B offers coverage for medically necessary physical therapy up to certain amounts. For 2017, those caps are:

  • $1,980 for physical therapy and speech-language pathology services combined
  • $1,980 for occupational therapy services

However, there are some exceptions that provide more coverage if you qualify.

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Medicare doesn’t cover everything. Luckily, those on Medicare can now start saving on out of pocket expenses like prescription drugs, dental, vision, hearing, and more. Over 1 million people have already received their free Medicare Plus Card.

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Medicare World Editorial Team
The Medicare World editorial team works diligently to make sure our stories are informative, unbiased, and of utmost relevance to our readers. Our team of researchers and writers presents the best and latest information on all things Medicare, including legislation, enrollment rules, changes in coverage and costs, and health information. We enjoy keeping our readers up-to-date and helping them navigate the often-complicated Medicare maze.

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