Physical therapy is essential after knee replacement. Most patients complete 16–36 sessions over 6–12 weeks. Full recovery typically takes 3–6 months.
Outpatient Physical Therapy (Knee Replacement)
16–36 sessions over 6–12 weeks · Covered under Part B
Minimum (16 sessions)
$374
6 wks × 2–3×/wk
Typical (24 sessions)
$562
8 wks × 3×/wk
Extended (36 sessions)
$842
12 wks × 3×/wk
2026 PT Threshold: $2,330
Once your total PT charges exceed $2,330 in a calendar year, Medicare requires your provider to add a KX modifier certifying continued medical necessity. If the modifier is missing or denied, Medicare may stop covering additional sessions and you pay 100% out of pocket.
Important: If you used PT earlier this year for any other condition (back pain, fall recovery, etc.), those charges count toward the same $2,330 threshold. Ask your PT provider how much of your threshold has already been used before starting post-surgical PT.
Durable Medical Equipment (DME)
Walker, crutches, knee ice pack · Covered under Part B
Medicare Part B covers DME at 80% after your Part B deductible. You pay 20% coinsurance.
CPM machines and ice therapy machines are generally NOT covered by Medicare. These can cost $100–$400 out of pocket if prescribed.
Home Health Care
Skilled nursing + PT visits at home · Covered at $0 if eligible
Medicare covers home health at $0 patient cost for covered services — no deductible, no coinsurance.
Eligibility Requirements (all 3 must be met):
Your doctor certifies you are homebound (leaving home requires considerable effort)
You need skilled nursing care, physical therapy, or speech therapy
Care is provided by a Medicare-certified home health agency
Common Misconception
Many patients assume they automatically qualify for home health after surgery. In reality, Medicare only covers skilled care — nursing wound care, PT, or speech therapy. Non-medical personal care such as cooking, bathing, dressing, or companionship is not covered by Medicare, regardless of how recently you had surgery. If you do not qualify, private-pay visits typically cost $130–$200/visit. Ask your surgeon about home health eligibility before discharge.
Skilled Nursing Facility (SNF)
Short-term rehab after inpatient stay · Days 1–20 free, Days 21–100 cost $217/day
Days 1–20
$0
Fully covered
Days 21–100
$217/day
Coinsurance
Most knee replacement patients stay fewer than 20 days — meaning SNF care is often fully covered. Requires a qualifying 3-day inpatient hospital stay.
⚠ Observation Status Disqualifies SNF Coverage
SNF coverage requires a formal inpatient admission of at least 3 consecutive days. If the hospital placed you under "Observation Status" instead of formally admitting you, your stay is billed under Part B (outpatient) — and you do not qualify for SNF coverage, regardless of how many nights you spent in the hospital.
Before discharge, ask your care team: "Am I formally admitted as an inpatient, or am I under observation status?" This single question can save thousands of dollars in SNF costs.
Complete Out-of-Pocket Picture
Run your Cost Estimate first to see surgery-specific numbers. The recovery ranges below are based on 2026 Medicare rates.
$394 – $862