How many days does Medicare allow you to stay in rehab?
Asked by: Germaine Mann | Last update: October 14, 2025Score: 4.1/5 (40 votes)
How many days do you get in rehab with Medicare?
Medicare covers inpatient rehab in a skilled nursing facility – also known as an SNF – for up to 100 days. Rehab in an SNF may be needed after an injury or procedure, like a hip or knee replacement.
What is the length of stay for rehab?
Some inpatient stays are considered short-term rehab and can last from 28 to 30 days, while others are considered long-term rehab and last for 60 days to 90 days or longer, depending on the person's level of need, treatment goals, and the program's structure.
How many days of therapy does Medicare pay for?
There's no limit on how much Medicare pays for your medically necessary outpatient therapy services in one calendar year.
What is the 60 rule in rehab?
The 60% Rule is a Medicare facility criterion that requires each IRF to discharge at least 60 percent of its patients with one of 13 qualifying conditions.
Does Medicare Cover Short-term Rehab After A Hospital Stay?
What is the 8 minute rule for rehab?
What is the 8-Minute Rule? To receive payment from Medicare for a time-based CPT code, a therapist must provide direct treatment for at least eight minutes. Providers must add the total minutes of skilled, one-on-one therapy and divide by 15. If eight or more minutes remain, you can bill one more unit.
What happens when you run out of Medicare days?
What happens if I run out of Original Medicare Part A coverage for a hospital stay? After 90 days, when Medicare Part A stops paying, you can use up to 60 lifetime reserve days, but you'll pay a steep copay. In 2025, it's $838 per day.
What is the 21 day rule for Medicare?
You pay nothing for covered services the first 20 days that you're in a skilled nursing facility (SNF). You pay a daily coinsurance for days 21-100, and you pay all costs beyond 100 days. Visit Medicare.gov, or call 1-800-MEDICARE (1-800-633-4227) to get current amounts.
What is the 3 hour rule for inpatient rehab?
Generally, the therapy intensity requirement is met with 3 hours per day 5 days per week or 15 hours per week. The patient must receive a minimum of 15 hours per week of therapy services, unless documentation supports medical issues justifying a brief exception not to exceed three consecutive days.
What is the average length of stay inpatient?
The average length of stay (LOS) for a hospitalization is 5½ days. Unnecessary days in hospital may lead to increased hospital-acquired patient complications (e.g., healthcare-associated infections, falls) and increased costs for patients and healthcare systems.
What is long-term rehab?
Long-term rehabilitation programs typically provide a variety of services to help patients recover from substance use disorders. While in a rehab facility, patients participate in individual and group therapy, as well as other activities that are beneficial for their recovery.
What to do when Medicare runs out for rehab?
If you need continued care after your Medicare coverage for a rehabilitative skilled nursing stay ends, you have various at-home and residential options that you can pay for with private funds until they are exhausted, then apply for Medicaid, Doyle says. If you have no assets, you can apply for Medicaid.
How many days does Medicare cover inpatient?
Inpatient hospital care
Once you meet your deductible, Part A will pay for days 1–60 that you are in the hospital. For days 61–90, you will pay a coinsurance for each day. If you need to stay in the hospital for longer than 90 days, you can use up to 60 lifetime reserve days.
How much does inpatient physical rehab cost?
Cost Breakdown of Inpatient Physical Rehab
30-Day Stay: Total costs range from $6,000 to $30,000, depending on the facility and patient needs. Additional Fees: Specialized services such as physical therapy, occupational therapy, and equipment rentals can add several thousand dollars to the bill.
How many days will Medicare pay for rehab?
As mentioned, the first 20 days in the rehab facility are covered in full by Medicare. Some Medigap/Supplemental co-insurance policies will cover all or part of the $204 daily co-pay for days 21-100. But patients do not always qualify for the full 100 days of rehabilitation.
What is the 7 month rule for Medicare?
It lasts for 7 months, starting 3 months before you turn 65, and ending 3 months after the month you turn 65. My birthday is on the first of the month. If you miss your 7-month Initial Enrollment Period, you may have to wait to sign up and pay a monthly late enrollment penalty for as long as you have Part B coverage.
What is the maximum Medicare days?
Original Medicare covers up to 90 days of inpatient hospital care each benefit period. You also have an additional 60 days of coverage, called lifetime reserve days. These 60 days can be used only once, and you will pay a coinsurance for each one ($838 per day in 2025).
What are the 6 things Medicare doesn't cover?
- Eye exams (for prescription eyeglasses)
- Long-term care.
- Cosmetic surgery.
- Massage therapy.
- Routine physical exams.
- Hearing aids and exams for fitting them.
How many days is a patient typically in a skilled nursing facility?
Understanding Skilled Nursing
These rehabilitative facilities typically function as short-term care, with the average stay lasting between 20 – 38 days.
What is the 72 hour rule for inpatient rehab?
What is the 72 hour rule? If a patient is admitted to the hospital and avails diagnostic services within even three days before being admitted to the hospital then these services are considered inpatient services and are included in the inpatient payment, i.e. bundled.
What is rehab period?
60-Day Program
A 60-day addiction treatment program may involve a stay at a residential or inpatient facility for 2 months or 8 weeks, or it may involve an outpatient program that lasts about the same amount of time.
How long should a rehab session be?
A typical physical therapy session lasts 30 to 90 minutes and is scheduled 2-3 times per week. In most cases, treatment may begin immediately following your physical therapist's initial evaluation. Additionally, most patients will attend an evaluation and follow-up sessions for a faster healing process.