THE LIBERATION OF THERAPY PRACTICES: A RESPONSE TO APTA’S POLICY WINS IN THE 2025 MEDICARE FEE SCHEDULE

The American Physical Therapy Association (APTA) has long championed the fight for equitable access to therapy, reduced administrative burdens, and policies that empower physical therapists (PTs) and physical therapist assistants (PTAs) to operate at their full potential. The recently announced changes in the 2025 Medicare Physician Fee Schedule Final Rule mark a significant step forward in that fight.

The introduction of general supervision for PTAs and the reform of therapy plan of care certification requirements demonstrate progress, but the journey for transformative change continues. These updates represent not only a liberation for therapy practices but also a commitment to prioritizing patient care over paperwork.

General Supervision of PTAs: Increasing Access and Flexibility

Under the new rule, Medicare has shifted from requiring direct supervision of PTAs in outpatient settings to general supervision, aligning this policy with other Medicare settings and 49 state licensure laws. This change is monumental.

• Why It Matters: In rural and underserved areas, where patients are 50% more likely to receive therapy from a PTA, the outdated supervision requirements created unnecessary barriers to care. General supervision empowers PTAs to deliver essential services more efficiently, ensuring that millions of Medicare beneficiaries maintain access to high-quality therapy without logistical delays.

• What It Means for PTAs: With this change, PTAs can practice to the fullest extent of their training and licensure, relieving staffing challenges in clinics and fostering a collaborative environment where both PTs and PTAs contribute meaningfully to patient outcomes.

Streamlining the Plan of Care Certification Process

The reform of the plan of care certification requirement addresses a long-standing administrative hurdle. Previously, PTs were responsible for obtaining a physician’s signature within 30 days of submitting a plan of care—a process fraught with delays that could disrupt treatment and jeopardize payment.

• The New Standard: PTs now need only submit the plan of care to the referring physician within 30 days of the initial evaluation, with no requirement to secure the physician’s signature.

• Impact on Patient Care: By eliminating this bureaucratic bottleneck, PTs can dedicate more time to what matters most: treating patients. This reform reduces stress on therapy practices and ensures uninterrupted care for beneficiaries.

Advocating for Financial Stability in Therapy Services

Despite these wins, the continued reduction of the Medicare conversion factor—slated for a 2.83% decrease in 2025—casts a shadow on the progress made. Cuts to therapy payments threaten the financial stability of practices already stretched thin. APTA’s advocacy for the Medicare Patient Access and Practice Stabilization Act, which proposes a 4.73% payment boost, is a critical next step to counteract these reductions.

The Bigger Picture: A Call to Action

These policy changes underscore the power of sustained advocacy and collective action. However, the fight for therapy practice liberation is far from over. We must continue to push for:

• Full-scale reform of the Medicare Physician Fee Schedule to ensure sustainable payment rates for therapy services.

• Legislative support for measures like the EMPOWER and REDUCE Acts, which further dismantle outdated barriers to care.

• Increased recognition of the essential role PTs and PTAs play in improving population health.

A Path Toward a Brighter Future

APTA’s recent victories are a testament to the resilience and dedication of the physical therapy community. They are also a reminder that meaningful change is possible when we work together. By embracing these policy advancements and continuing to advocate for systemic reforms, we can create a healthcare landscape where therapy practices thrive and every patient has access to the care they need.

The liberation of therapy practices is not just about policy changes; it’s about empowering providers, expanding access, and ensuring that the focus remains squarely on patient well-being. These wins are a step in the right direction, and we look forward to a future where physical therapy is fully supported and recognized as a cornerstone of healthcare.

For more information on these changes and ongoing advocacy efforts, visit APTA.org.