APTQI Commends CMS for Heeding Physical Therapists’ Call to Expand General Supervision for Therapy Assistants and Reduce Administrative Burdens

While APTQI commends CMS for expanding general supervision for PTAs and OTAs for all physical therapy and occupational therapy services delivered in private practices and for including a plan of care provision that will reduce administrative burden and streamline patient care, APTQI also decries the -2.8% cut proposed for next year

Washington, D.C. –– The Alliance for Physical Therapy Quality and Innovation (APTQI) today commended the Centers for Medicare & Medicaid Services (CMS) for including several policies that physical therapists have long advocated for in the Medicare Physician Fee Schedule (MPFS) Proposed Rule for Calendar Year (CY) 2025.

Specifically, APTQI applauded CMS’ proposal to expand the general supervision for physical therapy assistants (PTAs) and occupational therapy assistants (OTAs) for all physical therapy and occupational therapy services furnished in private practices. APTQI strongly supports this provision, which will empower PTAs and OTAs to perform vital services for more patients.Previously, CMS had onlyallowed PTAs and OTAs to operate under general supervision of physical and occupational therapists when it came to Remote Therapeutic Monitoring (RTM).

Additionally, APTQI applauded the inclusion of a provision that would provide an exception to the physician/NPP signature requirement on the therapist-established treatment plan for purposes of the initial certification. This provision would apply to cases where a written order or referral from the patient’s physician/NPP is on file and the therapist has documented evidence that the treatment plan was transmitted to the physician/NPP within 30 days of the initial evaluation. This would help to reduce administrative burden and streamline patient care. APTQI has long called for these two policies and is pleased that CMS included them in the proposed rule for 2025. 

“We applaud CMS’ proposal to expand the general supervision for therapy assistants for all physical therapy and occupational therapy services delivered in private practices, and we commend CMS for heeding our calls to streamline patient care and decrease the serious administrative burdens PTs and OTs face when certifying a patient’s plan of care,” said Nikesh Patel, PT, Executive Director of APTQI. “Our members have fiercely fought for these changes for years and we are glad that CMS has listened to our concerns and responded with these proposals.”

“While we urge CMS to finalize these two important provisions, we also remain deeply concerned with the continued Medicare cuts the agency has proposed again this year,” continued Patel. “For physical therapists and the millions of Americans who rely on them for care, CMS’ proposed -2.8% cut is alarming. With costs rising, CMS’ continued cuts do not reflect the reality of practice operations and care delivery. As the proposed cuts threaten to undercut access to physical therapy care, we will be working with lawmakers in Congress to ensure Medicare reimbursement for physical and occupational therapy is stabilized so patients can maintain access to the care they need,” added Patel.

Specifically, APTQI expressed deep disappointment about CMS’ decision to again include deep, across-the-board payment cuts to physical, occupational, and speech therapy in the MPFS proposed rule for 2025. Years of successive cuts, continuing with the -2.8% cut proposed for next year, threaten the sustainability of physical therapy practices at a time when workforce costs and inflation are accelerating.

At the same time CMS proposed another serious cut, the agency also predicted that practice cost inflation will increase by 3.6%, suggesting a widening gap that physical therapy practices must manage on top of declining reimbursement. Unless blocked, this newly proposed cut will cause even more disruption for the thousands of community practices dedicated to helping older Americans prevent dangerous and debilitating falls, regain strength and mobility after a serious illness or injury, and improve their overall quality of life.

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