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  • 'Fundamentally Flawed': APTA's Comments on CMS' Plan Around PTAs, OTAs Target Potential Harms

    The big picture: a bad plan for determining when services are delivered by a PTA or OTA
    The US Centers for Medicare and Medicaid Services' (CMS) proposed physician fee schedule rule for 2020 includes provisions that would require providers to navigate a complex system intended to identify when outpatient therapy services are furnished by a physical therapist assistant (PTA) or occupational therapy assistant (OTA). If adopted, the plan would trigger a payment differential in 2022 based on how many minutes of services are provided by the PTA or OTA. (See this PT in Motion News story for a more detailed overview of the proposed rule.)

    CMS proposes to accomplish this by way of new PTA and OTA modifiers (CQ and CO, respectively) to be included on claims beginning January 1, 2020. The proposal also requires providers to add a statement in the treatment note that explains why the modifier was or wasn't used for each service furnished that day. In short, the system is rooted in total minutes of service, and would require the use of the applicable modifier that would indicate when a PTA or OTA provided outpatient therapy services for 10% or more of the total time spent furnishing the service.

    The proposal is more than just problematic—it's a threat to patient access to care, a vast overreach of CMS authority, and a documentation nightmare that flies in the face of CMS' "patients over paperwork" initiative to ease administrative burdens on providers. We laid out our concerns in a comment letter to CMS that describes the plan as "fundamentally flawed."

    Some of what's being proposed, CMS reasoning behind it—and what we have to say

    CMS: When the PTA participates in the service concurrently with the PT for a portion of total time, the modifier should be used when the minutes furnished by the therapy assistant are greater than 10% of the total minutes spent by the therapist furnishing the service, which means that the entire service would be subject to the 15% payment adjustment in 2022. This is being done to comply with Section 1834(v) of the Social Security Act.
    APTA: The intent of the therapist assistant provisions in the Social Security Act was to better align payments with the cost of delivering therapy services given that therapist assistant wages are typically lower than therapist wages. It was not meant to apply an adjustment to a PT's services furnished when the therapist assistant provides a “second set of hands” to the therapist for safety or effectiveness.

    The proposal completely ignores the efficacy of team-based care (CMS uses the term “concurrent“) and runs counter to the evolution—ostensibly supported by CMS—toward value-based care. "It is nonsensical to diminish reimbursement for services when safety precautions are implemented, and the overall value of the care is increased," we say in our letter. Bottom line: only services furnished in whole or in part independently by the assistant should count toward the 10% standard.

    CMS: If the PTA and the PT each separately furnish portions of the same service, the modifier would apply when the minutes furnished by the PTA are greater than 10% of the total minutes—the sum of the minutes spent by the therapist and therapy assistant—for that service.
    APTA: This proposal directly contradicts CMS' response to comments in the 2019 fee schedule final rule. In the rule, CMS explained how its claims processing system allows for the differentiation of the same procedure code when the same service or procedure is furnished separately by the therapist and assistant.

    In our letter, we write that “the agency clearly is contradicting itself now, several months later, in proposing to require that the CQ/CO modifier apply when the minutes furnished by the assistant are greater than 10% of the total minutes—the sum of the minutes spent by the therapist and therapist assistant for that service, thereby not allowing for the same procedure code to be reported on 2 different claim lines.”

    But that's just part of the problem. The system CMS is proposing for how providers arrive at this is anything but simple—in fact, we say that it's "outrageous that CMS expects therapy providers—particularly those who do not employ administrative staff and must perform all the coding and billing themselves in addition to delivering treatment to patients—to engage in division, addition, multiplication, and rounding merely to determine whether to affix a modifier to the claim."

    CMS: Beginning in 2022, if the PTA services exceed the 10% limit, reimbursements will be cut by 15%.
    APTA: The cuts pose a grave threat to the delivery of services, particularly in rural and underserved areas, especially when it's combined with the geographic indices that affect payment in these areas—on top of other potential reimbursement reductions in future years. We recommend that if CMS moves ahead with this proposal, it should exempt providers in rural and underserved areas from the requirements.

    CMS: In addition to the use of new modifiers, providers will need to provide a written statement explaining why the modifier was or wasn't used—and it has to be done for each service furnished that day.
    APTA: In our letter we call this plan "wholly unbelievable." Aside from the facts that the modifier proposal itself is extremely complicated and the extra documentation is not required by law, the addition of a statement requirement is clearly an undue administrative burden and a direct contradiction of the CMS "Patients Over Paperwork" initiative.

    We write that the plan "conveys a sense that CMS is being vindictive toward outpatient therapy providers, creating a divisive environment for therapy providers enrolled in the Medicare program." Our comment letter goes on to provide 6 additional reasons why the documentation requirement is a bad idea, including the ways in which it complicates 15-minute timed billing, exceeds requirements of Medicare administrative contractors, and applies a standard to PTs, OTs, PTAs, and OTAs that isn't applied to physicians, physician assistants, and nurse practitioners.

    What's next?
    This letter is the first of 2 comment letters on the fee schedule that APTA will be providing to CMS in the coming weeks. Deadline for comments is September 27, and the final rule will likely be issued by November 1. APTA and several other providers associations will be meeting with CMS officials in mid-September to share concerns and provide recommendations.

    You have an important role to play. Visit APTA's "Regulatory Take Action" webpage to access a customizable template letter on the PTA/OTA modifier, fill it in, and make your voice heard. It's easy—and crucial.

    Stay tuned for additional opportunities for comment on other elements of the proposed rule.


    • Does CMS cut reimbursement rates when a PA or NP delivers service ? Or require a modifier ?

      Posted by Lori Garone on 8/30/2019 5:06 PM

    • This is a detrimental to Assistants, noone will want to hire us because they will not get paid at the same rate, not only that it’s detrimental to patient care! It will be more work for the PT if they have to see a patient for a portion of each treatment and will just lead to Further career burnout for PTs! I feel as though they are trying to relegate assistants to the level of a tech, I didnt go to school and spend all that money to be considered a tech! Companies are already cutting PTA jobs with the expected upcoming changes in October! It’s only going to get worse. If they aren’t trying to treat PatAs as techs it sure feels like they are trying to push us out of the profession one wY or another. The service we provide are valuable and skilled regardless of it we have an associates degree or doctorate degree.

      Posted by Melissa Konechne on 8/30/2019 9:35 PM

    • Yes. Medicare reimburse PA and CNP at 85% of the physician fee schedule.

      Posted by Anonymous on 9/1/2019 6:31 AM

    • APTA, please create a social media profile picture badge and/or a simple infographic about this to create more buzz about this issue. This fleshed-out list is good, as well as on the APTA Take Action page, but we need something easy to share, with a quick link for more people to take action!

      Posted by Lisa Henderson on 9/2/2019 11:51 AM

    • You do realize that according to Medicare rules the PT must be present in the same office suite for a PTA to see the patient for Part B that means that a PTA can not stand alone you must have a PT. This is different from a PA or NP which is why they want to do this. In rural settings this is already difficult and costly now you have reduced reimbursement by 15 %. Most profit margins are less than 15 %. Also it is not fair that a PTA can work alone in all other settings for a portion of the time. PTA's are valuable to our profession. We have PTA's in our clinic that have incredible manual therapy skills and deep compassion for what we do.

      Posted by Katy Baker on 9/4/2019 12:57 PM

    • The clinical skills offered by CPTAs quickly exceed today’s DPTs.Time matters. Sadly, an eval post procedure is, in reality, an educated guess. success depends on communication. Build our DPTs up, but know a PTA/OTA spent 90%more time with the customer. Quality care post eval is what matters. A good worker should be paid for the quality of care provided, not by the minute. Ask the patient, or family. Especially the most prolonged stays or challenging circumstances. TEAM work matters. Sometimes it’s the CNA. I could go on and on. Be the best and try to stay humbled by the greatness keenly eyeing everything you accomplish.

      Posted by Andrew Robertson on 9/4/2019 7:01 PM

    • well since it's obvious that PTAs are being phased out, can we at least get more programs to allow for a transition from PTA to DPT. (more than just two in the whole US) I payed waaay to much money and learned way to much just be made obsolete due to insurance. PTAs should be allowed to challenge the DPT licensure.

      Posted by Joshua Klas -> CIWaCN on 9/5/2019 12:32 AM

    • This proposed flaw is that you, as the apta, are supporting the idea of screwing over the PTA as Melissa Konechne so clearly put it. You guys are wondering why the PTA membership is so low and are trying to find ways to up their numbers in the APTA, but you continue to only support ideas that support the PT only and screw over the profession of the pta. Your mission Statement is to support both the PTA and pt as equal yet your actions say otherwise. There is no reason why I, as a PTA should get paid 85% while you, supporting the PT only, should make 100% for the same sit to stand exercises, the same SLR, etc....APTA working for you....that is a joke...sure isn't working for me

      Posted by Kyle Suarez PTA on 9/5/2019 5:29 AM

    • I agree that this would compromise patient care further. It would most definitely be a documentation nightmare and lead to a decreased use of the PTA. The current system already accommodates for treatment provided by a PTA with delineation of the eval, re eval and joint mobilization/other interventions exclusive to the PT. This would threaten the PTA degree and further threaten and/or weaken the PT profession.

      Posted by Dr Mary Stout on 9/5/2019 6:48 AM

    • Any argument to thwart this proposal will have to be strong enough to illustrate differences between services provided by therapists/therapist assistants vs. physicians/physician assistants or any physician extender. What we should be focusing on is the commercial payers. Especially, those commercial insurance networks that manage State Medical Assistant plans via offspring LLC's these same networks own and 'cherry-pick' Medicare policy to their extreme benefit.

      Posted by David Bullock on 9/5/2019 9:12 AM

    • If this is CMS's approach to cutting costs, they are barking up the wrong tree. I have been a PTA for 37 years and have provided skilled PT treatments as efficiently and effectively as possible. There are evaluations and specialty areas that only the PT can be billed for but most other PT treatments are and should be billed the same. This proposal is not fair or sensible to the PTA or the PT/OT profession.

      Posted by Anne Reilly on 9/5/2019 10:10 AM

    • I agree with Lisa, "APTA, please create a social media profile picture badge and/or a simple infographic about this to create more buzz about this issue.” This response to CMS is a good first step by the APTA (I’ve been critical in the past but I can give just deserts when appropriate) and I'm thankful to see some action on this front. I feel the APTA should reach out to ALL licensed PT/PTAs, not just members for advocacy efforts. As a member, I and my fellow private practice owners have felt the APTA has been overly tame and ineffective with its support of our profession. This language in this prepared response to CMS is very welcome. Ramp it up, Keep it up and expand this topic into the social media and target all stakeholders, clinicians and general population alike. Really draw the contrast between what we do in the outpatient setting, when it’s done right, to manage pain and dysfunction without narcotics. I feel this is a great opportunity to reposition our profession as a first choice for many musculoskeletal and neuromuscular derangements during this time of changing the healthcare paradigm. This might end up being the catalyst that can help with the current gap in reimbursement and salary requirements for DPTs and PTA's alike, or it could just be another slam to our profession. Step it up APTA.

      Posted by Joe on 9/5/2019 11:30 AM

    • As I look to replace a departing PTA in 2 months, I have the opportunity to hire another very solid PTA, but wonder if this will be problematic in the near future. Its very difficult to find PT's/PTA's... and nurses, doctors, etc in the rural area where I live. But I wonder how much of an admin and budgetary nightmare this will be. If I don't hire this PTA, I may go 2 years without finding another provider. I may have to lay off support staff. And people with, say, an ankle sprain that could be better in 4-5 weeks, then get back to their life, may now have a life issue with this tricky ankle for the rest of their life, if they can't get in to be seen. What is the reasoning behind the 85% cut anyway? If they are saying services provided by PTA's aren't as valuable, why are they paying for them at all? In the evidence based era, is there evidence that services supplied by PTA's are less effective? Or is it just saving money? This is like having a 4 wheel car and saying tires are too expensive, so I'm going to cut off one wheel to save money on tires. You just ruined your car.

      Posted by James on 9/5/2019 12:15 PM

    • This true APTA should work for both PT and PTA AS A TEAM not with degrading the Profession. How many times APTA changed their VISION 2020?.

      Posted by Seihu on 9/5/2019 11:37 PM

    • From the comments so far, it should be obvious that the APTA needs to continue not only avoiding this infringement to therapy, but also to fight the change in pay being implemented in October.

      Posted by Jonathan Lee on 9/7/2019 12:01 AM

    • A line item modifier should be based on the PTA doing a percentage of the procedure, not total treatment time.

      Posted by Rick Wickstrom on 9/7/2019 6:52 AM

    • Let's get real here. This has been coming on for a very long time. Clinics and facilities have long been squeezing every drop of Medicare money that they can get out of every treatment, AND every patient. PTs, and especially PTAs, have been used as money making tools. Medicare is going broke and yes, our services are now rightfully being scrutinized under a microscope. I am sad for those of us who went into this profession thinking it was more than about money. We have been ruined by greed - NOT Medicare.

      Posted by Marie on 9/8/2019 7:31 AM

    • The APTA does it again. In their comments to CMS they basically say, "it's okay to cut reimbursement when a PTA does a treatment" I suggest to the APTA they study negotiating tactics. It is NOT okay to cut reimbursement at all, under any circumstances when a PTA does the treatment. There is a reason they are licensed! That license should allow us to get fully reimbursed when we utilize a PTA. And how dare the APTA to suggest otherwise. The APTA goes "belly up" too often!

      Posted by James F. Resing, PT, DPT on 9/8/2019 11:26 AM

    • One of my biggest concerns with this proposal is that companies will just use aides as PTAs instead of hiring PTAs. A well trained aide will be looked upon as someone who can do all the work as a PTA (aside from manual treatments) and then the company can still bill as a PT only saw them because aides aren't legally allowed to do that type of work. Cutting corners doesn't help anyone and the only people that are going to be hurt by this new rule are patients.

      Posted by Jennifer Arpin -> @KR`BJ on 9/8/2019 4:07 PM

    • Hi Marie. Your comment: "Clinics and facilities have long been squeezing every drop of Medicare money that they can get out of every treatment, AND every patient. PTs, and especially PTAs, have been used as money making tools." reminds me of when I worked for some larger corporations who were motivated by ROI, not patient outcomes. However, please consider the cost to CMS for a RTC or meniscectomy. We can agree these procedures cost CMS upwards of $10k, not to mention pain, suffering and in the case of the knee, eventually a really expensive TKA in terms of $ and painful recovery. Now, let’s contrast this with what we now know through evidence-based research, of which the APTA has made noteworthy progress in aligning our profession to more consistent treatment parameters, and the non-surgical recovery with just good old physical therapy. We now understand that these procedures are contraindicated until a competent physical therapist, physical therapy assistant team have seen the patient prior to surgery. In terms of the financial costs, the current cap for Medicare is $3,000 per patient per year. I believe most therapists observe this cap with regards to medical necessity, just because the audits over this amount have been made really cumbersome for the back of the house. We can agree this is a lot less expensive than the surgical choices, plus the added benefit of the rising tide of improved health and well-being is a valuable secondary benefit. Additionally, our clinic routinely addresses comorbidities and add additional treatment diagnosis because we believe treating the whole patient is our mandate, not just the knee or ankle. I don’t think this is “squeezing” CMS, I think this is being a responsible provider who is doing the patient and CMS a great service especially if we can avoid future falls and injuries leading to more costs. I think it's a good idea to step back sometimes and consider the entire healthcare landscape, evaluate where our profession currently is and where we should be in order to assess the cost to benefit analysis of our services. I would argue that PT is still the BEST value and still the most underutilized services in healthcare. Just my perception though.

      Posted by Joe on 9/11/2019 11:41 AM

    • If attempting to align with the APC to physician model then PTA's should be reimbursed at 100% if care completed incident to the PT and 85% if PTA is treating without in-suite supervision. This is not to align, this is to cut cost to CMS. If we areoving toward a value-based payment model then we should be reimbursed on outces regardless of the degree.

      Posted by Cynthia Long on 9/11/2019 4:55 PM

    • I have been working with a PTA, using the team approach for the past 10 years. She is my right hand. To say her services are worth less is insulting to me and to her. She is invaluable to me and to the patients we serve. We work in a rural area where half of our patient volume is Medicare. This will be a huge hit to the profession, no only my practice.

      Posted by Jacquie on 9/18/2019 12:12 PM

    • Medicare reimbursement cuts should not happen.

      Posted by Kayla Petzold on 9/18/2019 2:48 PM

    • I have been working as a LICENSED PTA for about 5 years, with experience in acute care, SNF settings, and outpatient setting. In my few years of service to this profession I believe I have helped countless patients improve their quality of life, to the best of my abilities. Now I am reading about this change in insurance that is like a slap in the face to my title, because again we are LICENSED professionals, with people who have little to no education in our field of study, telling us that we are not worthy of reimbursement, which I believe is ridiculous. If this change occurs the PTs will be dealt increased stress that is not needed and the PTA will be phased out with patients taking the greatest hit. This revision is so much more than about saving money, this proposal will affect the patient, the reason we all went to school. I see this as a corrupt attempt to undermine the profession of Physical Therapy. Also, to bring in a personal note, I am married and soon to be a new father.. With this reduction in reimbursement my profession is at risk and places the livelihood of my family at risk, which is the main reason I am commenting, because this does not only affect the profession, but it affects the therapist who has humbly served others and affects their families. I pray that our profession is not infringed upon, because we make a difference, whether whomever is pushing this believes that or not. That is all I have to say for now.

      Posted by For all PTAs on 9/21/2019 10:32 AM

    • I hope this won't affect PTA careers too much. If you think about it PTAs are still a good deal even with 85% reimbursement, as we certainly don't make 85% of a PT salary, regardless of how much experience you have or how hard we work as a profession. No surprise that nobody will have our back on this, the APTA has never been a great advocate for the profession in general, and certainly not for PTAs. Their advanced proficiency pathways the only advancement opportunities for PTAs, and they are expensive, time-consuming, and certain to not be reflected in your paycheck when it's all said and done. You might as well go to PT school. Which you probably can't afford, unless you're much closer to that 85% than I am and don't have a family to support. After 8 years as a PTA, I've learned to assume the position. If you want to be advocated for, appreciated, and given advancement opportunities, might want to look at other careers.

      Posted by PTA on 9/23/2019 8:33 AM

    • We use a team approach with patients. This going to be a billing nightmare. The PTA's are very qualified to do a multitude of tasks. We practice in a rural setting. So we are already paid the least, yet have to be competitive in salary and benefits for all the staff. We run on a break even budget as it is. We provide quality care. This will effect if I can keep PTA's in my practice since we are also limited in NYS that PTA's can not tx worker's comp pt's. So what will happen to the PTA's? Reimbursement is not all about salaries. It is about the cost of the practice to do business. The cost of the support staff and operational costs. Our PTA's are very important to PT's and to the patient's they are assisting with. We do not work like a medical PA, NP. The treatment is mixed w/ both professionals. In outpatient we have to have direct PTA supervision. What are they going to do with the Home Care PTA ?

      Posted by Alice Fadden on 9/24/2019 9:12 AM

    • This is truly unfortunate for the PTA profession. If this goes forward, I see the decrease in the number of available PTA positions as well as our value. This is a slippery slope that the CMS is proposing. As individuals who attended schooling and were tested to obtain a LICENSE to practice I, quite frankly, as a PTA am outraged. I've been used for entire treatments for patients with the PT only seeing the patient for eval, 30 day note and discharge. It infuriates me that I am supposedly only worth 85% of the 100% that I've given to my patient. Furthermore, due to being worth only 85% our careers are at risk due to a difference in profit. Our patients whom we care for to the best of our abilities will also lose. We spend the same amount on continuing education as any PT but is that now looked upon as though we are only 85% as competent in those same classes? (Barring that the skill falls within our scope of practice) The timely delivery of services may very well be limited due to the decreased value placed upon our profession by individuals unknowing of our value other than dollars and cents. Even if I was to choose to go back to school for the PTA to DPT program, there are 2 nationally. Needless to say none in my area and who can now quit a job to attend more schooling out of state after having already paid for my education. There are 4 year PTA programs out there, again a very limited number. At no point can you even begin to consider a 4 year program when you would still be a PTA with a license that would only be good for 85%. As a LICENSED PTA, I am scared for my livelihood and for my patients as they too will suffer. I guess Medicare is a business, I won't go into the government using it as it's personal loan bit, it's running out of money but for fear of the fund running out they are willing to let patient care suffer. I DONT see the value in that at all

      Posted by Undervalued PTA on 9/24/2019 9:16 AM

    • Once again they are trying to squeeze money out of the hard working professionals actually doing the hands on care. Therapy is cost effective and relatively cheap compared to surgery and injections. This will limit the access to therapy services and create hardship for clinics trying to meet the need and have funds to reward those PT's that are taking on the extra responsibility to supervise their PTA counterparts who are doing an excellent job. Once again they are going after the little guy and not addressing where most of the money is spent.

      Posted by CRAIG HAWKINS on 9/27/2019 12:47 PM

    • None of these proposed cuts have anything to do with pt care. I have been a PTA for 9 years. I have always worked in settings that take a team approach to treating patients. If it wasn't for the PTA's the PT's would be extremely overworked. These cuts and changes see to only be trying to phase out small clinics. PTA's will be out of a job and patients will not get the care they need due to lack of help.

      Posted by Amanda Clement on 9/27/2019 12:56 PM

    • To Leadership of APTA by a non-member senior PTA Fellow therapists , I ll be honest with you, your counter proposal to CMS is hypocritical and degrading the PTA role in healthcare. What you should have done is making a proposition not about amount of PTA % of treatment that is over complicated but about experience and seniority for PTAs for less pay cut than a new grad. It is not fair for someone working 10-30 years as PTA have equal pay cut like a new grad. If CMS needs to budget and minimize therapy costs should be vertically not horizontally without taking into account years of experience education and training , so the more experience you gain the pay rate also will increase as the medicare will pay companies also a bit more. You should make a proposition to CMS for classify rate per billing modifiers as PTA-I , PTA-II PTA-III with scale % cuts 15%-5% with both parties compromise and after that work harder across the country on promoting to Part time schools programs for working PTAs to move up to MS degrees and finally be a PT so the gap between PTAs-DPTs is not so wide that now everybody looking down upon PTAs.. If you not stop this, the Association will perish with few brave and overwhelmed Therapists DPTs and the PTA workforce as profession will end up been on a level of technician underpay that will be always be afraid may do something wrong. Also you need to do a honest self-criticism of your Bylaws BYLAWS OF THE AMERICAN PHYSICAL THERAPY ASSOCIATION https://www.apta.org/Policies/FullPacket/ count how many times is the word "NO" for PTAs regarding vote rights and leadership ranks. If our own Association is not trusting us , why CMS should. Proteus

      Posted by PTA class 2007 on 11/11/2019 11:39 PM

    • We PTA's have been let down by our APTA. The APTA has done little to protect our careers. When I graduated in 1993 in San Antonio, Texas this city graduated about 20 PTA's a year. Now this city graduates at least 80 and that number is growing with another new program opening in 2020. This is just San Antonio, I'm sure other cities have experienced the same oversaturation of PTA's. Why does our APTA accreditate so many programs for PTA's? While advancing accreditation standards for PT's they allow oversaturation of PTA's. You PT's and MPT's need to pay attention. Once we're gone you my become the "new and improved" PTA to DPT's.

      Posted by Reyes Nino on 11/26/2019 9:09 PM

    • So should I give up on my dream of being a PT or PTA? I wanted to work with people to help them and start as a PTA, but the options of transition from PTA to PT are so few in numbers and it seems PTAs are going to become nonexistent due to this cut. I feel like getting hired is going to be impossible because paying a PTA isn’t going to be cost effective. I am distraught. It makes me want to pull out of all my classes. I am scared...

      Posted by Rubie Luna on 11/26/2019 9:20 PM

    • I agree with concept that PTA should be regulated more and PT should be performing more interventions than passing it on to tech or PTA. The patient deserves best course of treatment and the PT is the best way to deliver this. Now saying that , the APTA should focus its energy on transitioning the PTA to Bachelor that would make the PTA treatment in a particular area of Physical therapy rival the PT. Once the PTA has ability to move up education ,then arguments can made about payment equality.

      Posted by Chris on 12/7/2019 7:34 AM

    • I have to agree with the majority of the comments. Having been a PTA for over 20 years, I believe I have high level of knowledge and skills. I have worked in all settings mainly out pt. I work closely with my supervising PTs in a team effort and feel that the treatment I provide is beneficial to my patients. While working on my BS degree I worked as a tech in a rehab setting which made me decide on PTA school because the PTAs were the ones spending the most time with the Pts. Years ago I contemplated going back to school for PT. Now I’m wishing I would have. With 2 kids and a wife in college I just can’t do that right now. This truly scares me for my future and ability to support my family. The APTA needs to step up and support us. The company I work for now pays PTAs 65-70% of what they pay PTs already.

      Posted by Jay on 1/9/2020 1:10 AM

    • I feel so ignorant for not being aware of this issue. I'm a traveling PTA and was fortunately warned by my current boss that this was a reality. I worked so hard to get my degree, get several years of experience, then go down the exciting road of traveling while doing what I love...now, it will all have to come to an end?? I wouldn't have ever thought I'd have to truly consider a career change.

      Posted by Nikayla TeLindert on 1/12/2020 11:00 PM

    • I have really wanted to get into the PTA or PT field and I feel sad to hear of all these changes on the horizon. Is it even worth it to go for PTA anymore>? do I just stick to trying to become a PT? whhhyyyyy arent there more bridge options. ???

      Posted by Jenessa Manion on 2/15/2020 1:45 AM

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