The win is a continuation of APTA’s efforts to promote the adoption of payer policies that are favorable to the profession and patients.   

Aetna's Policy Improvements for Physical Therapists

APTA advocacy efforts have led to improvements in Aetna policy so that it more appropriately represents the breadth of physical therapists' practice and clinical judgement.

In its Medical Clinical Policy Bulletin for physical therapy updated Oct. 29, Aetna made several changes that were recommended by APTA.

The bulletin now has a more comprehensive and accurate description of the practice of physical therapy. The policy document also references telehealth platforms as a way to facilitate physical therapy.

Additionally, the payer removed the requirement that patients be homebound in order to access home-based PT services.

This APTA advocacy win follows a significant win from this summer, when Aetna updated its physical therapy policy to provide unrestricted direct access to physical therapist services, giving more than 26 million Americans covered by Aetna the option of direct access to PT services.

Additional changes in the policy bulletin include: 

• The removal of a reference to direct supervision for PTAs, bringing the requirement in line with Medicare and the 49 states that allow for general supervision of PTAs.
• An expanded description of gait training that acknowledges the complex connection of various body systems. 
• A more thorough and accurate definition of neuromuscular reeducation and therapeutic exercise describing the numerous benefits and clinical implications of the intervention without reference to "standard" visits or episode duration. 

How the Advocacy Process Works With Payers

APTA Health Policy and Payment Senior Specialist Alice Bell, PT, DPT, has built a strong relationship with Aetna over the past decade. Following changes earlier this year to direct access, she was able to escalate member concerns about some of the text in the policy document. 

"We could not have these advocacy wins without our members," Bell said. "Our members are not only an important voice in the advocacy process, but they alert us to any policy issues that may be causing problems for the profession. It's crucial that we work together to bring change."

2025 Successes

This update is one example of several from this year that demonstrate the strength and results of APTA's advocacy with payers: 

• APTA Advocacy Leads to Noridian Updated Guidance on Plan of Care Signature
• APTA Advocacy Win: Anthem Changes Payment Policy to Document Total Time per Code
• APTA Advocacy Impact: Novitas Updates FAQ With Plan of Care Signature Exception
• APTA Advocacy in Action: UHC Lessens Prior Authorization Burden for PT Visits Under Many MA Plans

APTA members can join the APTA Advocacy Network to receive action alerts on policy and payment issues and more. Contact APTA's advocacy staff with any questions or concerns about payer policies.