Use and Supervision of Physical Therapist Assistants

Stephanie Maxwell, Cristina Boccuti, Kathryn Tong

The Balanced Budget Act of 1997 required Medicare prospective payment systems and fee schedules to be implemented for post-acute and outpatient rehabilitation providers. These policy changes may increase the use of cost-reducing practices in rehabilitation, including the use of group therapy, “concurrent” therapy, and assistants to furnish care in lieu of therapists. To assess the minimum requirements under which rehabilitation services must be furnished, this paper analyzes Federal and state regulations regarding physical therapists (PTs) and the use and supervision of their assistants. Medicare requirements for supervision of PT assistants vary by provider type; regulations also vary by state. As background, the paper also describes the educational training requirements, current socio-demographic characteristics, and 1990-2000 national employment estimates regarding PTs relative to PT assistants. (Published by the Centers for Medicare and Medicaid Services; 2002 April.)

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