Medicare typically covers up to 100 days of inpatient rehabilitation after hip replacement, though most patients use far fewer. The exact length and type of rehab coverage depends on where you recover: a skilled nursing facility, an inpatient rehab hospital, or your own home with visiting therapists. Each setting has different rules, costs, and qualifying criteria.
Skilled Nursing Facility Coverage: Up to 100 Days
The most common post-surgical rehab setting for hip replacement patients is a skilled nursing facility (SNF). Under Medicare Part A, you’re covered for up to 100 days per benefit period. The first 20 days are fully covered after you pay the Part A deductible, which is $1,676 in 2025 (rising to $1,736 in 2026). From day 21 through day 100, you pay a daily coinsurance of $217 (2026 rate). After day 100, Medicare stops paying entirely, and you’re responsible for the full cost.
In practice, most hip replacement patients don’t stay anywhere close to 100 days. A typical SNF rehab stay after hip replacement runs two to three weeks. Medicare will keep covering the stay as long as you’re making progress and still need skilled care. Once your therapy team determines you’ve plateaued or can safely continue recovery on your own, coverage ends regardless of how many days remain in your 100-day window.
The 3-Day Hospital Stay Rule
Before Medicare will cover any SNF stay, you must have spent at least three consecutive days as an inpatient in a hospital. This is one of the most important and most misunderstood rules in Medicare. Time spent under “observation status” in the hospital does not count toward the three days, even if you were physically in a hospital bed. If your hospital stay is shorter than three days or classified as observation, Medicare will not pay for SNF rehab, and you’d be responsible for the full cost out of pocket.
After discharge from the hospital, you generally need to enter the SNF within 30 days for the stay to qualify. The rehab must also be related to the condition you were hospitalized for.
Inpatient Rehabilitation Facilities
Some hip replacement patients qualify for a more intensive option: an inpatient rehabilitation facility (IRF). These are specialized hospitals where patients receive at least three hours of therapy per day. Medicare Part A covers IRF stays, and the coverage structure is similar to a regular hospital admission rather than the SNF 100-day framework.
Not every hip replacement patient qualifies for an IRF. Medicare sets specific criteria for who needs this level of intensive care. For hip replacement specifically, you generally qualify if you had bilateral hip replacements during the same hospital stay, if your BMI is 50 or higher, or if you’re 85 or older. Patients who don’t meet these criteria are typically directed to a SNF or home-based rehab instead.
Home Health Rehab After Hip Replacement
Many hip replacement patients skip facility-based rehab entirely and recover at home with visiting physical therapists. Medicare Part A covers home health services with no coinsurance and no deductible, making it the least expensive option for patients. There’s no fixed day limit on home health coverage. Medicare will continue paying as long as you need skilled therapy and meet the homebound criteria.
To qualify as homebound, you need to have trouble leaving your home without help, such as needing a walker, wheelchair, crutches, or another person’s assistance. Leaving home must require what Medicare calls “a major effort.” You can still leave for medical appointments or short, infrequent outings like religious services and remain eligible. For most people recovering from hip replacement, especially in the first few weeks, the homebound requirement is easy to meet.
Home health therapy is part-time and intermittent, meaning a therapist visits your home several times a week rather than providing all-day care. As your mobility improves and you no longer meet the homebound definition, home health coverage ends, and you’d transition to outpatient therapy.
Outpatient Physical Therapy
Once you’re mobile enough to travel to a clinic, Medicare Part B covers outpatient physical therapy. There’s no hard cap on the number of visits, but there is a financial threshold that triggers extra scrutiny. In 2026, if your combined physical therapy and speech therapy charges exceed $2,480 in a calendar year, your therapist must document that continued treatment is medically necessary. Below that threshold, claims process normally. Above it, claims without the proper documentation are denied.
You pay 20% of the Medicare-approved amount for each outpatient therapy visit after meeting your Part B deductible. Most hip replacement patients need outpatient therapy for six to twelve weeks after surgery, though the timeline varies based on your age, overall fitness, and how quickly you regain strength and range of motion.
How Benefit Periods Work
Medicare’s 100-day SNF limit resets with each new “benefit period.” A benefit period starts the day you’re admitted as an inpatient and ends when you’ve gone 60 consecutive days without receiving any inpatient hospital or skilled nursing care. Once that 60-day clock runs out, a new benefit period begins the next time you’re admitted, and the 100-day SNF count resets to zero.
This matters if you have complications or need a second surgery. If 60 days have passed since your last inpatient stay, you’d get a fresh 100 days of SNF coverage, though you’d also owe the Part A deductible again.
Medicare Advantage Plans May Differ
Everything above applies to Original Medicare (Parts A and B). If you have a Medicare Advantage plan (Part C), your rehab benefits must be at least as generous as Original Medicare, but the process of accessing them can be different. An estimated 99% of Medicare Advantage plans require prior authorization for at least some services, which means your plan may need to approve your SNF stay or therapy visits before they begin. Denials and delays are more common with Advantage plans, and coverage details like copay amounts, preferred facilities, and network restrictions vary by plan.
If you’re on a Medicare Advantage plan, check your plan’s evidence of coverage document before surgery so you know which rehab facilities are in network, whether prior authorization is required, and what your daily copay will be. These details can differ significantly from Original Medicare’s standard cost structure.
Typical Rehab Timeline After Hip Replacement
Most people recovering from hip replacement follow a predictable path through Medicare’s rehab options. The hospital stay itself is usually one to three days. From there, patients either transfer to a SNF for one to three weeks of inpatient rehab or go directly home with home health therapy. After a few weeks, most patients transition to outpatient physical therapy at a clinic, continuing for roughly six to twelve weeks total from the date of surgery.
The total amount of rehab Medicare pays for is less about a fixed number of days and more about medical necessity. As long as your doctors and therapists can document that you’re benefiting from skilled care and haven’t yet reached your recovery goals, Medicare generally continues to cover treatment across each of these settings. The 100-day SNF limit is a ceiling, not a guarantee, and most hip replacement patients finish their rehab well before reaching it.