How soon after a knee or hip replacement can I drive myself to therapy?

Your surgeon decides, but the American Academy of Orthopaedic Surgeons gives the usual markers. For both surgeries, driving is generally safe once you are off opioid pain medicine and your strength and reflexes are close to normal. After a knee replacement, most people drive again about 4 to 6 weeks after surgery, once the knee bends enough to sit comfortably and the leg reacts fast enough to brake.

Does Medicare pay for a ride to physical therapy?

Original Medicare does not pay for car or wheelchair van rides. Its ride benefit is an ambulance, covered when any other vehicle could endanger your health and you need care at a hospital, critical access hospital, rural emergency hospital, or skilled nursing facility. A Medicare Advantage plan may offer rides as an extra benefit, so ask the plan whether therapy visits are included.

Is there a limit on how many therapy visits Medicare covers?

There is no hard cap. For 2026, once a patient's outpatient therapy charges pass $2,480 (one amount for physical and speech therapy combined, and a separate $2,480 for occupational therapy), the therapist adds a code confirming the care is medically necessary and documented. Claims past $3,000 can be picked for targeted medical review. The rides stay your job either way.

What happens to my Medicaid rides when my therapy visits run out?

The rides end with the covered visits, because Medicaid transportation follows covered care. In Washington, adults get 24 units of physical therapy a year without authorization, about six hours, with up to 24 more for certain diagnoses such as a joint replacement. Texas authorizes adult therapy in periods of up to 60 days, to a maximum of 120 days for one acute condition. Ask the therapist to request more visits before the current ones run out.

How many cardiac rehab sessions does Medicare cover?

Up to 36 one-hour sessions, at most two a day, over as long as 36 weeks, with 36 more if the Medicare contractor approves them. Intensive cardiac rehab allows up to 72 one-hour sessions, up to six a day, over as long as 18 weeks. At one session a day, a full 36-session course means 72 one-way rides.

Does workers' comp pay for the ride to physical therapy?

Often, with approval from the insurer, and the rules come from your state. Washington's rule, for example, pays travel to authorized treatment only when the nearest adequate care is more than 15 miles from home one way, and it does not pay the first 15 miles in each direction. Ask the claims adjuster before the first visit, and keep receipts.

Transportation to Physical Therapy: Who Pays

Why therapy rides need a schedule, not a call each time

Therapy is a course of visits with a start and an end, so the rides should be booked the same way. The end usually comes from paperwork, not from how the patient feels. Under Medicare, a physician or other practitioner certifies the therapy plan for whatever length the patient needs, up to 90 calendar days. The plan must be recertified at least every 90 days, or sooner when it changes significantly (Medicare Benefit Policy Manual, Chapter 15, section 220.1.3). Medicaid programs add their own visit limits and authorization periods, covered below.

That gives a family or case manager three dates to track:

The first visit. After a joint replacement, that can come within days of surgery. OrthoInfo says most knee replacement patients stay in the hospital one to three days, and outpatient patients go home the same day.
The authorization or plan end date. Rides paid by Medicaid stop when the covered visits stop.
The day the patient can drive again. After that, the ride is no longer needed at all.

Cardiac and pulmonary rehab work the same way, only longer. A full Medicare course is 36 sessions, and at one session a day that is 72 one-way rides.

When the patient can drive again

Joint replacement patients usually need rides for the first several weeks. The American Academy of Orthopaedic Surgeons gives these markers on its OrthoInfo pages:

Both surgeries. Driving is generally safe once the patient is off opioid pain medicine and strength and reflexes are close to normal. The surgeon makes the call.
Knee replacement. Most people resume driving about 4 to 6 weeks after surgery, once the knee bends enough to get in and sit comfortably and the leg reacts quickly enough to brake and accelerate.

OrthoInfo also says a physical therapist may work with a knee patient at home or at a therapy center for the first few weeks. Home visits need no ride, so ask which one the plan calls for before booking anything.

Comfort in the car matters on the way home from a session. For hip patients, OrthoInfo suggests firm pillows on car seats so the knees sit lower than the hips. Mild to moderate knee swelling can last three to six months, and raising the leg helps, so ask for a seat with legroom on longer rides.

Who pays for the ride

Each payer treats the ride differently from the therapy. Most cover the visit and leave the ride to someone else.

Original Medicare. Medicare pays for outpatient therapy, but its only ride benefit is an ambulance. Part B covers an ambulance when any other vehicle could endanger the patient’s health and the care is at a hospital, critical access hospital, rural emergency hospital, or skilled nursing facility. Car and wheelchair van rides to a therapy clinic are not covered. Our guide to Medicare and NEMT has the details.
Medicare Advantage. A plan is not required to provide rides to routine care, but it may offer them as a supplemental benefit, arranged or provided by the plan and used only for health care (Medicare Managed Care Manual, Chapter 4). Ask whether therapy and rehab visits count and how many rides a year the plan allows. More in our guide to Medicare Advantage rides.
Medicaid. The ride follows the therapy benefit. CMS says states must assure transportation to the optional benefits they choose to cover, and therapy for adults is one of those choices. Children under 21 are covered more broadly; Washington, for example, covers unlimited outpatient rehabilitation for members 20 and younger.
Workers’ compensation. The insurer pays travel to approved treatment under state rules, usually after approval. Washington’s rule (WAC 296-20-1103) pays only with prior authorization and only when the nearest adequate treatment is more than 15 miles from home one way, and it does not pay the first 15 miles in each direction. Our workers’ comp transportation guide covers other states.
Paying privately. Families who pay out of pocket can compare companies’ prices with our guide to senior transportation rates.

How Medicaid therapy limits end the rides

Three state rules show where rides paid by Medicaid stop for adults:

Washington. For members 21 and older, physical therapy without authorization is one evaluation, one reevaluation at discharge, and 24 units a year, which the rule says is about six hours. With expedited prior authorization, up to 24 more units are available for listed diagnoses, including a partial or total joint replacement, a stroke in the past 24 months, or complex fractures that needed surgery (WAC 182-545-200, as amended effective September 5, 2026).
Texas. Adult therapy is covered only for acute conditions. Each prior authorization covers no more than 60 days, a recertification can add another 60, and therapy for one acute condition stops at 120 days (Texas Medicaid PT, OT, and ST handbook, October 2026). Recertification requests must arrive no earlier than 30 days before the current period ends.
Missouri. Adult physical therapy is not a covered service. If the MO HealthNet Division approves a provider’s exception request, transportation may then be approved for those visits. Missouri also caps the trip: a therapy clinic must be within 30 miles of home in urban, basic, and rural counties alike, unless an exception applies.

The pattern is the same in all three. When the visits are not authorized, the ride is not either, so the therapist’s authorization request and the ride request move together.

Cardiac and pulmonary rehab: count the sessions first

Rehab programs run long, so the number of rides is the number to plan around. Medicare covers up to 36 one-hour sessions of cardiac or pulmonary rehab and up to 72 of intensive cardiac rehab, under 42 CFR 410.49 and 42 CFR 410.47. Who qualifies and the limit for each program:

Program	Who qualifies	Medicare limit
Cardiac rehab	Heart attack in the past year, bypass, stable angina, valve surgery, a stent or angioplasty, heart or heart-lung transplant, stable heart failure	Up to 36 one-hour sessions, two a day at most, over up to 36 weeks; 36 more with contractor approval
Intensive cardiac rehab	The same conditions	Up to 72 one-hour sessions, up to six a day, over up to 18 weeks
Pulmonary rehab	Moderate to very severe COPD, or COVID-19 with breathing problems lasting at least four weeks	Up to 36 one-hour sessions, two a day at most, over up to 36 weeks; 36 more with contractor approval

Million Hearts, the federal heart disease prevention initiative, calls 36 one-hour sessions the optimal cardiac rehab course.

Two sessions on the same day share one round trip, so ask the program whether it schedules back-to-back sessions. That can halve the rides on a long course.

Book the ride around the therapy plan

A recurring ride, often called a standing order, saves calling before every visit. Some programs require the clinic to set it up. In Virginia’s fee-for-service Medicaid program, the health care provider must schedule standing rides, for up to six months at a time, and physical or occupational therapy and rehabilitation are on the list of services that qualify. In Missouri, a standing order needs recertifying every 90 days, and a hospital stay switches it off until a new one is arranged.

A setup that holds up:

Get the plan details from the therapist. Visit days, times, and the date the plan or authorization ends.
Ask who books the standing ride. In some programs it is the clinic, not the patient.
Describe the patient’s mobility honestly. A walker, crutches, a wheelchair, or help from the door all change the vehicle the ride line sends.
Match the end date to the authorization. If the therapist gets more visits approved, extend the ride the same day.
Cancel early when a visit is canceled. Virginia’s handbook asks for 24 hours’ notice when possible.
End the ride when the patient can drive. It frees the slot and keeps the record clean.

For a case manager booking for someone else, our guide to scheduling Medicaid transportation for a patient covers what the ride line asks for.

For the company that drives these patients

Therapy schedules shift: a visit moves to the afternoon, a week gets skipped, the plan ends early. In HealthRide, a recurring trip lets the dispatcher change a single day without breaking the weekly pattern, and end the series when care changes. See how recurring trips work.

Transportation to physical therapy and rehab: who pays for the rides, and how to set up a recurring schedule