Outpatient Therapy Limits


Each year, the Centers for Medicare & Medicaid Services (CMS) announces updated coverage limits for certain services.

This table shows the changes in the coverage limits by service:


Physical and speech therapy, combined $2,480
Occupational therapy $2,480

Therapy services beyond the Medicare coverage limit will be covered by PacificSource with an approved prior authorization. See your Evidence of Coverage for more information.


Physical therapy 10 visits
Speech therapy 10 visits
Occupational therapy 10 visits

Therapy services beyond the 10 visit limit will be covered by PacificSource with an approved prior authorization. See your Evidence of Coverage for more information.