Beyond the Gridlock: What’s Actually Happening in Physical Therapy Right Now
What it looks like vs. what’s actually happening
If you’ve been paying attention to Congress lately, it probably feels like nothing is getting done. Budgets are stalled, big debates are going nowhere, and most of the headlines focus on dysfunction.
And to be fair…that part is true.
But underneath all of that noise, something important is happening for physical therapy.
On April 22, 2026, about 75 private practice PTs went to Capitol Hill to advocate for the profession. It didn’t make national news, but it matters. A lot.
Because while Congress may feel stuck, these smaller, targeted efforts are quietly shaping what physical therapy will look like, especially heading into major payment changes in 2027.
2. The big swing: trying to undo payment cuts
One of the biggest efforts right now is the RECOVER Act, a bill aimed at removing a policy that reduces payment when physical therapists perform multiple procedures in the same session (MPPR).
Here’s the honest take:
- It’s expensive (around $14 billion over 10 years)
- It’s currently being led by Representative Deborah Ross and looking for co-sponsors
- It’s unlikely to pass as-is
So why introduce it?
Because it starts the conversation.
Think of it less like a final solution and more like setting the starting point for negotiations. It puts the issue on the map and gives advocates something concrete to push against in future discussions.
You can read more about MPPR in our previous blog.
3. A shift toward independence: opting out of Medicare
Another important bill on the table is the Medicare Patient Choice Act.
If passed, it would allow PTs (along with other rehab providers) to opt out of Medicare and work directly with patients through private contracts.
That’s a big deal.
Right now, Medicare largely dictates how care is billed and delivered. This bill would give providers more control, but it’s still early:
- A few cosponsors in the House
- Interest in the Senate, but no movement yet
- Still in the “building support” phase
In simple terms: the idea is gaining traction, but it’s not close to the finish line yet.
4. The SAFE Act: Making Fall Prevention Part of Preventive Care
The SAFE Act is centered around something much more practical than politics: catching fall risk before a serious injury happens.
The bill would add fall prevention screenings into Medicare wellness visits, so older adults who may be at risk can be identified earlier and referred to physical therapy when appropriate.
Here’s how it would work:
- During a Medicare wellness visit, patients would be screened for fall history and fall risk
- If concerns are identified, they could then be referred to a PT for a more complete falls assessment and preventive services
- The goal is to intervene earlier, before a fall leads to hospitalization, loss of independence, or long recovery periods
In many ways, the bill reflects a broader shift in healthcare thinking: not just treating injuries after they happen but preventing them in the first place.
For PTs, that’s significant.
It positions physical therapy as part of proactive, preventive care, not just something patients are sent to after surgery or injury. And for older adults, it could create earlier access to support that helps them stay mobile, safe, and independent longer.
The bill continues to gain support while advocacy groups work to educate policymakers on the value of fall prevention and early PT involvement.
5. Fixing one of the biggest headaches: prior authorization
If you’ve ever dealt with prior auth, you already know it slows everything down.
The Improving Seniors’ Timely Access to Care Act is trying to fix that by:
- Creating a standard electronic system
- Setting clearer timelines
- Requiring transparency from insurance plans
This bill has strong support on both sides of the aisle and is likely to move forward.
At the same time, PT organizations are working on something more specific: a therapy-focused version that better reflects how rehab care actually works.
6. Keeping care consistent: the locum tenens push
Another issue being worked on is continuity of care.
Right now, rules around substitute providers (locum tenens) are limited by geography. The Prevent Interruptions in Physical Therapy Act aims to fix that, so PTs can bring in coverage more easily when needed.
The challenge?
Some policymakers are worried about potential misuse.
Advocates believe this comes down to misunderstanding how physical therapy clinics actually operate, and they’re working to clear that up.
7. Why all of this matters (especially for 2027)
There’s a bigger deadline driving all of this: January 1, 2027.
That’s when major Medicare payment changes could take effect and potentially reduce reimbursement if nothing is done.
Right now, the focus is on:
- Preventing future cuts
- Creating inflation-based updates
- Adjusting outdated payment rules
Some short-term relief was passed for 2026, but that’s just a temporary bridge. The real decisions are still ahead.
The bottom line
It’s easy to look at Congress and assume nothing is moving.
But for physical therapy, that’s not really true.
There’s a steady push happening, bill by bill, meeting by meeting, to:
- Improve payment
- Expand autonomy
- Reduce admin burden
- Position physical therapy as a key part of preventive care
None of it is flashy. Most of it is slow.
But it’s building toward something bigger.
And the outcome will shape how physical therapists’ practice. Not just next year, but for the next decade.
Want to learn more? Stay tuned for our upcoming blogs.
