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The Issue
Medicare permits general supervision of physical therapist assistants by physical therapists in all settings — except for outpatient private practice under Part B, which requires direct supervision. Physical therapists and physical therapist assistants are governed by their state's practice act and must follow their state licensure requirements if they are more stringent than Medicare’s. However, 49 states permit "general supervision" of physical therapist assistants in outpatient practices, making Medicare’s direct supervision requirement in that setting more burdensome than most state licensure requirements.
Why It Matters
PTAs play a crucial role in the PT-PTA team and help bridge the gap in access to care. Instead, the current direct supervision requirement makes it harder for this access to be provided and threatens physical therapy businesses, particularly in rural and underserved areas where beneficiaries are 50% more likely to receive therapy from a PTA. Enactment of the EMPOWER Act (H.R. 4878/S. 2459) would standardize the supervision requirement from direct to general for private practices, help ensure continued patient access to needed therapy services, and give practices more flexibility in meeting the needs of beneficiaries.
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Recommended Content
Mar 22, 2024 / Position Paper
Enactment of EMPOWER Act would standardize the supervision requirement from direct to general for private practices, help ensure continued patient access to needed therapy services, and give practices more flexibility in meeting needs of beneficiaries.
Nov 3, 2021 / Review
Despite a few bright spots, the final rule mostly follows the proposed version, making Capitol Hill the only remaining hope for relief.
Oct 13, 2021 / News
The SMART Act would delay implementation, spare rural and underserved areas, and relieve PTA supervision burdens.
Aug 20, 2021 / Open Access
What you need to know about the system's origins, the law that created it, and the ways APTA has been advocating for the profession.
Aug 4, 2021 / News
A recent letter to House and Senate leaders says it's the wrong system at the wrong time.
Additional Eliminating the Direct Supervision Requirement of PTAs under Medicare Part B Content
Mar 15, 2024 / News
After putting the move on hold for three months, the insurer implemented the reduction March 1.
Nov 1, 2023 / News
Aetna put its decision on hold, giving APTA time to press for a permanent shift. Other news from the insurer isn't as good.
Mar 21, 2023 / News
The resource center, created by APTA and APTA Private Practice, now offers information on MPPR, the PTA differential, and more.
Sep 20, 2022 / Roundup
Here's the status of APTA-supported legislation on the fee schedule, telehealth, prior authorization, the PTA differential, and more.
Sep 7, 2022 / News
Policy research cosponsored by APTA reveals potential savings through eased PTA and OTA supervision requirements.
Aug 1, 2022 / Roundup
District offices, town halls, maybe a visit to your clinic? Here are some topics worth mentioning.
May 10, 2022 / News
Representatives are urging an APTA-backed move to general supervision for PTAs in outpatient settings.
Mar 11, 2022 / News
The $1.5 trillion plan passed with bipartisan support. Here are three takeaways of interest to the physical therapy community.
Mar 8, 2022 / News
Remember that old saying, "strike while the iron is hot"? Things are hot on Capitol Hill (and there's still time to act).
Feb 9, 2022 / News
In a joint letter to congressional leaders, APTA and 11 other groups urge adoption of legislation to address the PTA payment cut.