@sueinmn That was what was confusing to me, that being a federal program the states might have different rules for administering it. When I was much younger I actually worked in Blue Cross in Boston, within the Medicare administration department so I am somewhat familiar - things haven't changed that much.

When I went for PT, and I went a number of times for different things, at least monthly I had to fill out a form that was sent to Medicare showing my progress. It was difficult to fill out because not remembering what I had said the prior month I sometimes checked boxes that would indicate I was worse than I had been the prior month! Judging your ability and your pain is very subjective. I went to more than one PT place too and all three required that.

My relative in MA never had any of that! He went for quite a while after a hip replacement too so it just seemed strange. I realize the basic rules cannot vary but perhaps the administration of them can?
JK