Occupational Therapy

What is occupational therapy?

Occupational therapy (OT) helps you relearn the skills of everyday life after you have been ill or injured. You may learn new ways to:

eat
cook
dress
use a computer or wheelchair.

Occupational therapists work with physical or speech therapists, nurses, and doctors to coordinate care.

When may occupational therapy be needed?

You may need OT if you have had:

a stroke or other type of paralysis
lung disease
broken bones that make it hard to do everyday tasks
a head injury
a hand injury or surgery
joint replacements
severe vision problems, including blindness
any illness or injury that affects your ability to do your job.

What does an occupational therapist do to help me?

The therapist helps you learn ways to do everyday tasks despite your disability or illness. The therapist may:

Teach you shortcuts and how to use adaptive equipment such as reachers, visual aids, special kitchen utensils, or bathroom aids.
Make hand splints and show you how to do hand exercises.
Evaluate your home or workplace and suggest ways to do things more easily and safely.

Where do I get occupational therapy?

Therapy can be done in the hospital, in a therapy clinic, or at home.

What is the Medicare coverage for occupational therapy?

If you need therapy when you are a patient in the hospital, the therapy is part of the total bill and is covered by Medicare Part A. Medicare pays the hospital a specific rate based on your medical problem. You are responsible for the deductible.

Medicare helps pay for medically necessary occupational therapy when:

Your doctor or therapist sets up the plan of treatment.
Your doctor periodically reviews the plan to see how long you will get therapy.

Medicare will pay 80% of an OT bill that it approves. You pay the remaining 20%. You must also meet your deductible for the year.

In some cases, you may be billed additional fees by the occupational therapist. This occurs if the OT does not accept the amount Medicare pays as payment in full.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File GEN4419F.HTM Release 9.0/2006