This Act allows Medicare to apply existing temporary coverage rules, similar to those for doctors, when a physical therapist uses a temporary substitute provider.
Ben Luján
Senator
NM
The Prevent Interruptions in Physical Therapy Act of 2025 ensures continuity of care by allowing physical therapists to utilize locum tenens arrangements under Medicare. This legislation updates existing rules to ensure that temporary coverage for outpatient physical therapy services is treated the same way as coverage for physicians' services. The goal is to prevent disruptions in patient access to necessary physical therapy.
New Act Ensures Physical Therapy Stays on Track: Medicare to Cover Temporary Therapist Swaps
The Prevent Interruptions in Physical Therapy Act of 2025 is a short, sharp piece of legislation focused entirely on fixing an administrative hiccup in Medicare. Simply put, this bill ensures that if your physical therapist (PT) needs to step away for a short period—say, for illness or vacation—and brings in a temporary replacement (known as a locum tenens), Medicare will pay for those services without a hitch. The core change is extending existing Medicare rules, which currently apply mainly to doctors under section 1842(b)(6) of the Social Security Act, to cover physical therapists providing outpatient services. This change kicks in immediately for services provided after the bill becomes law.
The 'Whoops, Where's My Therapist?' Problem
Think about physical therapy. It’s often a continuous process—you might need several sessions a week for weeks or months after surgery or an injury. If your regular PT is unavailable, even for a week, that interruption can seriously derail your recovery. Before this bill, the rules around temporary coverage (locum tenens) were clear for physicians, but less so for PTs, creating a potential billing nightmare for clinics and uncertainty for patients needing uninterrupted care. This bill cuts through that ambiguity by explicitly stating that PTs get the same administrative treatment as doctors when using temporary coverage.
Keeping Your Recovery on Schedule
What does this mean for the person juggling a job and trying to recover from a knee replacement? It means stability. Imagine you’re a construction worker relying on your PT sessions to get back on the job, or a software developer trying to regain mobility after a car accident. If your therapist had to take an emergency leave, this bill ensures the clinic can bring in a qualified substitute and bill Medicare seamlessly. This avoids the situation where a clinic might hesitate to use temporary coverage due to billing complexities, forcing you, the patient, to pause your critical therapy sessions. The goal here is simple: continuity of care for Medicare beneficiaries.
Small Fix, Big Impact for Clinics
For the physical therapy clinic owner, this is a welcome bit of administrative streamlining. By aligning PTs with physicians under the same coverage rules, the bill removes a layer of complexity and risk when using temporary staff. It standardizes the payment process, making it easier for practices—especially those in rural areas where finding a permanent replacement can be tough—to keep their doors open and their patient schedules full. It’s a technical update, but one that removes friction from the healthcare system, benefiting both providers and the patients relying on their services.