As the 2025 legislative season has come to a close in most states, many APTA chapters achieved significant victories that improve payment, address provider credentialing, and reduce administrative burden.

Key successes include elevating the role of PTs in primary care, improving payment under Medicaid and workers’ compensation, expanding direct access, and reforming PTA supervision laws.

Here's a detailed look at the impactful changes APTA chapters drove this year.

Primary Care (Utah)

Advocacy efforts from APTA Utah resulted in landmark legislation that expands the definition of “primary care” to include PTs. The new law gives health insurers the discretion to allow an insured person to select a physical therapist as their primary care provider for neuromusculoskeletal conditions.  

Workers’ Compensation (Montana)

APTA Montana pushed for and won a revision to the definition of “treating physician” under the state’s workers’ compensation law to explicitly include PTs. This will allow for improved payment and direct access to PT services.

Provider Credentialing (Wyoming)

APTA Wyoming was successful in fighting for a new law that now requires health insurance carriers in the state to meet a 60-day deadline for the credentialing of a provider and to follow specified guidelines for the credentialing process.

Improved Direct Access to Physical Therapist Services (Oklahoma, Texas)

APTA Oklahoma was successful in advocacy for a new law, set to take effect Nov. 1, clarifying that licensed physical therapists operating under direct-to-employer contracts may treat patients without a referral for up to 30 days, consistent with the state’s PT direct access law.

Additionally, the Texas Physical Therapy Association was successful in expanding the treatment time for service provided via direct access from 10 to 30 days.

Medicaid (North Carolina, Arkansas, Colorado, Massachusetts)

Several states saw progress in expanding Medicaid access and payment.

Thanks to APTA North Carolina, Medicaid recipients over 21 will now be able to receive PT services at private practices. The state’s previous law limited payment for such services only to hospital-based clinics.

APTA Massachusetts was successful in advocating for increased reimbursement under the state Medicaid program for commonly used physical therapy codes by up to 78%.

APTA Arkansas’ advocacy efforts paid off, as the state’s Medicaid program is now required to reimburse for physical therapist services provided in a clinic-based setting.

APTA Colorado not only defeated a proposal that would have implemented a Multiple Procedure Payment Reduction for therapy services under Medicaid but also secured a 1.6% rate increase for physical therapists under the state’s Medicaid program. In addition, the chapter’s advocacy resulted in a new policy that prohibits the Colorado Department of Health Care Policy and Financing from imposing signature requirements beyond what is required by CMS when certifying a plan of care that involves PT services.

Prior Authorization (Indiana, Oregon)

APTA Indiana’s advocacy efforts resulted in a new law that prohibits utilization review entities from imposing requirements on prior authorization for the first 12 physical therapy visits of each new episode of care. In addition, a claim for reimbursement for a covered service or item provided to an insured person or enrollee may not be denied on the sole basis that the referring provider is an out-of-network provider.

APTA Oregon supported legislation that will require the Oregon Department of Consumer and Business Services to publish prior authorization data from insurers on denials, delays, and time frames for approval. The new bill also mandates that an insurer offering a health benefit plan that provides utilization review shall use a prior authorization application programming interface that will allow providers to determine whether prior authorization is required for a service and identify the information and documentation necessary to submit a request. 

Fair PT Copays (Ohio)

The Ohio Physical Therapy Association successfully fought for legislation that mandates that the cost-sharing requirement, on a per day basis, imposed by a health benefit plan for PT services shall not be greater than the cost-sharing requirement for an office visit to a primary care physician. Additionally, it requires a health plan issuer to clearly state on its website and on all relevant literature that coverage for PT services is available under the issuer's health benefit plans, as well as any related limitations, conditions, and exclusions. 

DPT Title Protection (Virginia)

Advocacy by APTA Virginia resulted in successful legislation protecting the titles “DPT” and “doctor of physical therapy” for use only by licensed physical therapists. 

PTA Supervision (South Dakota, Louisiana, Montana, New York)

Chapter advocacy efforts in Louisiana, Montana, and South Dakota led to reforms to the frequency of patient visits with the supervising PT when care is being provided by a PTA to provide more flexibility. 

Legislation advocated for by the New York Physical Therapy Association to change the supervision of PTAs from the current outdated direct supervision requirement to general supervision has passed the New York Legislature and is awaiting action by the governor.

Disability Placards (Wyoming, Arkansas, Arizona, Nevada)

Legislation in Arizona, Arkansas, Nevada, and Wyoming has passed to now include physical therapists among the list of health care providers authorized to certify applications for patients applying for a disability placard.

Diagnostic Imaging (Arizona, North Dakota, Rhode Island)

APTA Arizona was successful in enacting legislation that has expanded PTs’ diagnostic imaging order privileges to include all imaging for patients with established relationships and a clinical need. The law maintains the existing requirement that imaging must be performed by a qualified health care practitioner and interpreted by a licensed physician trained in radiology.

APTA North Dakota and APTA Rhode Island were also successful in advocating for legislation that authorizes PTs to order diagnostic imaging. In North Dakota, PTs who have met certain requirements can order musculoskeletal diagnostic imaging; an advancement from the previous law which limited PTs to ordering only plain film radiographs. Rhode Island PTs’ ability to order diagnostic imaging has been extended indefinitely, removing the original Dec. 31, 2025, expiration date.

Workforce (Nevada)

APTA Nevada scored two significant victories: authorizing PTs to participate in the Nevada Student Loan Repayment for Providers of Health Care in Underserved Communities Program, as well as becoming the 39th state to join the PT Interstate Compact.

Student Athlete Concussions (North Carolina)

APTA North Carolina added PTs to the state’s school concussion protocol, specifically authorizing PTs to evaluate and provide clearance for practice or return to play.

Telehealth Payment (New Jersey)

New Jersey extended certain pay parity for therapy services provided via telehealth until July 1, 2026.