How many PT visits does Aetna cover?

It depends on your specific plan; many have soft caps that can be extended with documented medical necessity. Verify the count against your own visit records.

Guides · Aetna · appeals · Updated July 2026

How to appeal an Aetna physical therapy denial

Aetna commonly limits physical therapy through visit caps and medical-necessity reviews, often ending coverage while you are still improving. Because the decision hinges on clinical documentation, these denials are frequently overturned on appeal.

Why Aetna denies this

Aetna typically denies continued PT as "not medically necessary" once a reviewer decides you have met goals or plateaued — code 50 territory. The reviewer relies on submitted notes, so thin documentation, not lack of need, often drives the denial.

What wins the appeal

Ask your therapist for detailed progress notes with objective measures and a clear statement that skilled therapy (not a home program) remains necessary. Add a letter of medical necessity. For visit-cap denials, request the exception process. File within 180 days (65 for Medicare Advantage).

Your deadline

Depends on your plan type: 180 days for most employer and marketplace plans, 120 for Original Medicare, ~90 for Medicaid, and only 65 for Medicare Advantage. Set it before you do anything else.

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Common questions

How many PT visits does Aetna cover?: It depends on your specific plan; many have soft caps that can be extended with documented medical necessity. Verify the count against your own visit records.