Medicare Part A pays for up to 100 days of rehab per benefit period in a skilled nursing facility, and up to 150 days per benefit period in an inpatient rehabilitation facility (90 regular inpatient days plus up to 60 lifetime reserve days). How many of those days you actually get covered depends on the setting you enter, whether you meet the eligibility rules, and whether your care stays medically necessary. The short answer to how many days Medicare will pay for rehab is: it depends on where you are and why you’re there, and the cost you owe changes as the days add up.
Skilled Nursing Facility: Up to 100 Days Per Benefit Period
A skilled nursing facility provides daily nursing care or therapy (physical, occupational, or speech) for people who need structured rehab but not hospital-level intensity. Medicare Part A covers up to 100 days per benefit period, split into two cost tiers for 2026:
- Days 1 through 20: Medicare pays in full. You owe $0 after meeting the Part A deductible of $1,736.
- Days 21 through 100: You pay $217 per day in coinsurance. Medicare covers the rest.
After day 100, Medicare pays nothing, and the full daily rate is yours. Reaching day 100 is uncommon, though. Medicare only keeps paying as long as you need skilled care and are meeting your treatment goals. If the facility decides you no longer meet those criteria, coverage can end well before you hit the cap.1Medicare.gov. Skilled Nursing Facility Care
The Three-Day Hospital Stay You Need First
Before Medicare will pay a dime for skilled nursing facility rehab, you need a qualifying inpatient hospital stay of at least three consecutive days. The count starts the day you’re formally admitted as an inpatient and does not include the day you’re discharged. You then have to enter the SNF within 30 days of leaving the hospital, and the care you get there must relate to a condition treated during the hospital stay (or one that arose while you were at the SNF). Custodial help alone, like assistance with bathing or eating, doesn’t qualify.1Medicare.gov. Skilled Nursing Facility Care
Watch Out for Observation Status
Time spent in the hospital under “observation status” does not count toward the three-day requirement, even if you slept in a hospital bed for several nights. Observation is technically outpatient, so those hours never accumulate. You can spend four days in a hospital room and still walk out with zero qualifying days.
Hospitals must give you a written Medicare Outpatient Observation Notice (the MOON) when you’re receiving observation services. If you haven’t received one and you’re unsure whether you’ve been formally admitted, ask directly. A skilled nursing stay that would otherwise be fully covered becomes entirely out-of-pocket if this detail slips by.2Centers for Medicare & Medicaid Services. Medicare Outpatient Observation Notice (MOON)
Inpatient Rehabilitation Facility: Up to 150 Days Per Benefit Period
Inpatient rehabilitation facilities are hospital-level settings for people recovering from serious events like strokes, spinal cord injuries, brain injuries, or major joint replacements. Unlike a SNF, an IRF stay does not require a prior three-day hospital stay. What it does require is a physician’s certification that you need intensive rehab with continuous medical supervision from an interdisciplinary team.3Medicare. Inpatient Rehabilitation Care Coverage
The therapy program generally involves at least three hours of therapy per day, at least five days a week, across multiple disciplines. CMS has clarified that reviewers should not deny coverage solely because a patient fell slightly short of the three-hour benchmark; coverage decisions should reflect the patient’s clinical picture, not a rigid time threshold.4CMS. Inpatient Rehabilitation Facility (IRF) Review Choice Demonstration (RCD) Review Guidelines
IRF stays fall under the inpatient hospital benefit. For 2026, the day-by-day cost tiers are:
- Days 1 through 60: Medicare pays in full after you meet the Part A deductible of $1,736.
- Days 61 through 90: You pay $434 per day in coinsurance.
- Days 91 through 150: You can draw on up to 60 lifetime reserve days at $868 per day. Lifetime reserve days are a one-time pool across your entire life. Once you use them, they don’t come back.
If you already paid the Part A deductible for a hospital stay in the same benefit period, you won’t pay it again when you transfer to the IRF. After 90 regular days and 60 lifetime reserve days are used up, Medicare no longer covers inpatient rehab costs in that benefit period.3Medicare. Inpatient Rehabilitation Care Coverage
How Benefit Periods Reset Your Day Count
Every day limit above is per benefit period, not per calendar year. A benefit period begins the day you’re admitted as an inpatient to a hospital or SNF. It ends after you’ve gone 60 consecutive days without inpatient hospital or SNF care. The next admission starts a new benefit period, and your day counts reset.5Centers for Medicare & Medicaid Services. Medicare General Information, Eligibility, and Entitlement Manual – Chapter 3
This shapes rehab planning. If you use 80 of your 100 SNF days, get discharged, spend 60 straight days at home, and then need SNF care again, a new benefit period starts, you get a fresh 100 days, and you owe a new Part A deductible. If you go back before those 60 days pass, you’re still in the same benefit period with only 20 SNF days left.
Lifetime reserve days are the exception. You get 60 across your entire life, no matter how many benefit periods come and go.
Medicare Can Keep Paying Even If You’re Not Improving
One of the most common reasons rehab coverage gets cut short is a determination that a patient has stopped improving. Improvement is not actually the legal standard. Under the Jimmo v. Sebelius settlement, CMS clarified that Medicare coverage for skilled nursing and therapy does not hinge on whether you have the potential to get better. Skilled care can be covered when it’s necessary to maintain your current condition or to prevent or slow further decline.6Centers for Medicare & Medicaid Services. Jimmo v. Sebelius Settlement Agreement Program Manual Clarifications Fact Sheet
The real question is whether the services require the skills of a therapist or nurse. If a facility tells you your coverage is ending because you’ve “plateaued,” that alone is not a valid reason for denial. It’s one of the most frequent grounds for a successful appeal.
Outpatient and Home Health Rehab
Inpatient settings aren’t the only way Medicare pays for rehab. If you don’t qualify for or don’t need an inpatient stay, two other paths exist.
Outpatient Therapy Under Part B
Medicare Part B covers physical therapy, occupational therapy, and speech-language pathology in outpatient settings like clinics. There’s no hard cap on visits, but once your therapy charges pass $2,480 (physical therapy and speech combined, or occupational therapy separately) in 2026, your therapist has to confirm that continued treatment is medically necessary. You pay 20% of the Medicare-approved amount for each session after meeting the annual Part B deductible.7Centers for Medicare & Medicaid Services. Therapy Services
Home Health Rehab
If you’re homebound and need skilled therapy, Medicare covers physical, occupational, and speech therapy through a home health agency. “Homebound” means leaving your home takes major effort because of illness or injury, not that you can never leave. There’s no fixed day limit, but services must be part-time or intermittent. Your doctor has to order the services, and a Medicare-certified agency has to provide them. There is no coinsurance or deductible for home health therapy under Part A. Coverage ends once you can safely do the exercises on your own or with help from family.8Medicare. Home Health Services Coverage
If You Have a Medicare Advantage Plan
Everything above describes Original Medicare. If you’re enrolled in a Medicare Advantage plan, the plan must cover at least the same rehab benefits, but the access rules can differ. Most plans require prior authorization before an IRF or SNF admission, restrict you to in-network facilities, and set their own coinsurance and copay amounts. A Medicare Advantage plan can also deny an IRF admission and steer you to a SNF instead. Your Evidence of Coverage spells out the specifics, and calling member services before a planned rehab admission is the cleanest way to avoid surprises.
Appealing an Early Cutoff
If a hospital, IRF, or SNF tells you Medicare is going to stop paying and you believe you still need care, you have the right to a fast appeal. In a hospital or IRF, you should receive a notice called “An Important Message from Medicare about Your Rights” within two days of admission and again before discharge. To trigger a fast appeal, contact the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) listed on the notice no later than the day you’re scheduled to leave. If you file on time, you can stay while the review happens, and the BFCC-QIO must decide within one day of receiving what it needs.9Medicare. Fast Appeals
In a SNF, you should get a “Notice of Medicare Non-Coverage” at least two days before covered services are set to end. Contact the BFCC-QIO by noon the day before your coverage termination date. Miss the deadline and you lose the right to stay in the facility during review. The Jimmo maintenance standard applies to these appeals too: needing skilled care to maintain function or prevent decline is a valid basis even if you’re not actively improving.
What You Pay After Medicare Stops
Once Medicare coverage ends, the full daily rate is yours. SNF costs vary widely but typically run several hundred dollars per day for a semi-private room. IRF daily rates are considerably higher because of the intensive therapy and physician oversight.
A Medigap (Medicare Supplement) policy covers some or all of the coinsurance during your covered days, and some plans add SNF days beyond what Original Medicare pays. Medicaid may cover long-term nursing facility stays for people who meet income and asset limits, though qualifying often means spending down savings first. Long-term care insurance, if you bought it before needing care, can also fill the gap. The time to plan for the possibility that Medicare’s coverage window runs out is before a rehab stay starts, not after the first out-of-pocket bill arrives.