As our health care system continues to evolve and adapt, so do APTA's public policy priorities. Coinciding with the new congressional session, APTA has released "APTA Public Policy Priorities, 2025-2026." This updated legislative and policy agenda reflects progress made in 2024, particularly on the Medicare Physician Fee Schedule, while focusing on how the profession can continue to have an impact moving forward.

Developed by the APTA Public Policy and Advocacy Committee, informed by a range of member experts, and approved by the APTA Board of Directors, the priorities establish a road map for the association's advocacy efforts on behalf of PTs and PTAs. The document reflects the changing state of the health care world, with specific references to the need to increase payment and decrease administrative burden, while recognizing emerging issues such as the use of artificial intelligence in health care.

Collaborating on Top Priorities

The eight-page document isn't intended to list every advocacy effort APTA will undertake in the next two years but instead highlights the overarching themes of APTA's legislative work. As in previous versions of this document, there are four core areas of focus:

• Patient Access and Care: APTA urges Congress and the administration to improve patient outcomes by eliminating barriers to health care services.
• Population Health and Social Determinants of Health: APTA urges Congress and the administration to enact policies that empower all people regardless of where they are born, live, learn, work, play, worship, and age to live healthy and independent lives.
• Value-Based Care and Practice: APTA urges Congress and the administration to facilitate and support payment infrastructures that will ensure that patients achieve the best outcomes commensurate with the cost of care.
• Research and Clinical Innovation: APTA urges Congress and the administration to prioritize research and clinical innovation to advance the science, effectiveness, and efficacy of physical therapist evaluation and management to optimize the health, well-being, and recovery of individuals, communities, and populations across the lifespan.

The priorities offer a high-level view for legislators, partners, and members to see what APTA is focusing on in terms of legislation and regulation, says APTA Vice President Skye Donovan, PT, PhD, who chairs PPAC.

Through the COVID-19 pandemic and the opioid crisis, more people are seeing the positive impact that the physical therapy profession can have on the health system, she says.

In a health care landscape that is far from static, it is critical that concerns of PTs and PTAs continue to be heard.

“Our health system is constantly changing and reforming, so we need to have a voice,” Donovan adds. “We are key opinion holders in not only improving patient outcomes but also provider well-being.”

Building on Previous Success

These priorities aren’t just talking points. Recent advancements show us that APTA advocacy can lead to crucial change.

The 2025 Medicare Physician Fee Schedule, which went into effect Jan. 1, included two key policy wins for the profession advocated for by APTA: changes to PTA supervision and plan of care certification. Both policies better support PTs and PTAs in their roles of improving the health of Medicare beneficiaries.

First, the supervision requirement for physical therapist assistants under Medicare Part B changed from the burdensome direct supervision requirement to general supervision. This aligns outpatient settings with the general supervision policy in place in all other Medicare settings.

The change provides more flexibility for the therapy workforce and ensures access to PT services for millions of Medicare beneficiaries, especially in rural or underserved areas. APTA had been advocating for this change to both the Centers for Medicare & Medicaid Services and Congress.

Former APTA Vice President Susan Appling, PT, DPT, PhD, says it’s “a huge win because it levels the playing field for outpatient private practices to allow PTAs to see patients with the physical therapist being off-site.” For example, Appling suggests PTs now can work on marketing their clinics or treating another patient off-site while the PTA is seeing patients in the clinic. Appling chaired PPAC during her term as vice president.

Second, the 2025 fee schedule includes an exemption to the burdensome plan of care signature requirement for outpatient therapy services provided with a referral from a physician. Under previous CMS policy, PTs had to send their plans of care to the referring physician, who then had 30 days to sign off on the services that the referring physician ordered in the first place. If the physician didn’t return the signed plan of care, it was the PT’s responsibility to follow up to obtain the signature or face not being paid by Medicare for services provided.

Any effort to reduce administrative burden in the profession can help PTs and PTAs spend more time with patients, Donovan says.

A Continuing Effort Toward Progress

Both Appling and Donovan recognize the important role that APTA and its members play in continuing progress in the years ahead.

"I've seen over the last 25 years the progress that we've really made and how we're not clawing to get there in the same way," Appling says. "We now have a seat at the table. We just have to keep pushing for reform to reduce administrative burden and improve payment. We have to continue to fight because if not us, then who will do this work? The answer is often no one. We have to continue to fight for our clients, our patients, and the people we serve."