Medicare covers rehabilitation for up to 100 days in a skilled nursing facility, with no fixed day limit for inpatient rehabilitation hospitals, outpatient therapy, or home health rehab. The exact duration depends on which type of rehab you need, whether you meet specific qualifying rules, and whether your care is considered medically necessary. Here’s how each setting works.
Skilled Nursing Facility: The 100-Day Limit
Medicare Part A covers up to 100 days of skilled nursing facility (SNF) care per benefit period. The first 20 days are fully covered with no out-of-pocket cost beyond your Part A deductible. Days 21 through 100 require a daily coinsurance payment of $209.50 in 2025. After day 100, Medicare pays nothing, and you’re responsible for the full cost.
To qualify for SNF coverage at all, you need a prior inpatient hospital stay of at least three consecutive days. This is sometimes called the “3-midnight rule.” The key detail many people miss: time spent in the emergency department or under “observation status” does not count toward those three days. Only formal inpatient admission counts. If you were in the hospital for four days but two of them were under observation, you may not qualify.
Most people don’t use all 100 days. Medicare will continue covering your stay only as long as you need skilled care, meaning care that requires the expertise of a licensed nurse or therapist. Once you no longer need that level of care, coverage ends regardless of how many days remain in your benefit period.
How Benefit Periods Reset Your Clock
A benefit period starts the day you’re admitted as an inpatient to a hospital or SNF. It ends when you’ve gone 60 consecutive days without receiving any inpatient hospital care or skilled nursing facility care. Once that 60-day gap passes, your benefit period resets. If you’re admitted again after that, a new benefit period begins with a fresh 100-day SNF allowance.
This means there’s no annual cap on SNF days in the way most people assume. If you have a hip replacement in January, use 30 SNF days, go home, stay out of inpatient care for 60 days, and then break your other hip, you get another 100 days. The practical challenge is meeting that 60-day gap and re-qualifying with a new three-day hospital stay.
Inpatient Rehabilitation Facilities
Inpatient rehabilitation facilities (IRFs) are hospitals or specialized units designed for intensive rehab, typically after stroke, spinal cord injury, brain injury, or major joint replacement. These are different from skilled nursing facilities. Patients in an IRF generally receive at least three hours of therapy per day.
Medicare Part A covers IRF stays, and there is no hard day limit like the 100-day SNF cap. Coverage continues as long as the care is medically necessary and you’re making progress or need skilled therapy to maintain your condition. However, IRFs must meet strict federal requirements. At least 60 percent of their patients must be treated for one or more of 13 qualifying conditions. This “60 percent rule” ensures that IRFs serve patients with genuinely intensive rehab needs rather than functioning as general nursing facilities.
The three-day prior hospital stay rule also applies to IRF admission under Part A. Your IRF team will work with Medicare to justify continued coverage based on your medical needs, and stays are reviewed regularly.
Outpatient Therapy Under Part B
If you’re recovering at home and visiting a clinic or therapist’s office, Medicare Part B covers outpatient physical therapy, occupational therapy, and speech-language pathology. There is no fixed number of visits or sessions per year. Congress permanently eliminated the old annual caps on outpatient therapy in 2018.
What replaced the caps is a threshold system. In 2026, once your physical therapy and speech therapy costs combined exceed $2,480 in a calendar year, your therapist must confirm on each claim that continued treatment is medically necessary. The same $2,480 threshold applies separately to occupational therapy. If costs exceed $3,000, your claims may be selected for targeted medical review, where Medicare examines the documentation more closely. But neither of these thresholds is a cutoff. Services above these amounts are still covered as long as they’re justified.
You pay 20 percent of the Medicare-approved amount for each outpatient therapy session after meeting your annual Part B deductible.
Home Health Rehabilitation
Medicare covers physical therapy, occupational therapy, and speech therapy in your home if you meet two conditions: you need skilled care, and you’re considered “homebound.” There is no day limit or visit cap for home health rehab.
The homebound requirement trips up many people. You qualify if leaving your home requires the help of another person, a wheelchair or walker, or special transportation due to illness or injury. You must also have a normal inability to leave home, and leaving must require considerable and taxing effort. You don’t have to be bedridden. Occasional trips to the doctor, a place of worship, or a short outing don’t disqualify you.
Home health visits are covered as long as they remain “part-time or intermittent,” which generally means up to 8 hours per day of combined skilled nursing and aide services, with a maximum of 28 hours per week. In some cases, your doctor can order up to 35 hours per week for a short period. Therapy visits happen as often as your provider orders them, and there’s no coinsurance for home health services covered under Part A.
You Don’t Have to Show Improvement
One of the most important and least understood rules in Medicare rehab coverage: you do not have to be getting better for Medicare to keep paying. A 2013 federal settlement known as Jimmo v. Sebelius clarified that Medicare cannot deny coverage simply because a patient has no potential for improvement. Skilled care is covered when it’s needed to maintain your current condition or to prevent or slow further decline, as long as that care requires the skills of a trained therapist or nurse.
The distinction is whether skilled personnel are needed. If your maintenance exercises could be carried out safely by you or an unskilled caregiver, Medicare won’t cover a therapist to do them. But if a therapist’s expertise is necessary to manage your condition, even without expected improvement, coverage applies. This matters most for people with chronic or progressive conditions like Parkinson’s disease, multiple sclerosis, or the aftereffects of a stroke.
What Happens When Coverage Ends
Before Medicare stops paying for your rehab in a SNF, IRF, or home health setting, you should receive a written notice called a “Notice of Medicare Non-Coverage” at least two days before your covered services end. This notice includes instructions for filing a fast appeal.
If you disagree with the decision, you can request a review by contacting the quality improvement organization listed on the notice. The deadline is tight: you must file no later than noon the day before your listed termination date. If you meet that deadline, your coverage continues while the appeal is reviewed, and you won’t be charged for the days under review unless the decision goes against you. Missing the deadline means you can still appeal, but coverage won’t continue during the review process unless the decision is reversed.
Fast appeals are worth pursuing if you believe you still need skilled care. The review is independent, and reversals do happen.