Robert Hall

On June 17, 2025, a long-awaited breakthrough in patient access to care arrived: Aetna officially removed its referral and signed plan of care requirements for physical therapy services. The Physical Therapy Clinical Policy Bulletin is available HERE:https://www.aetna.com/cpb/medical/data/300_399/0325.html. 

The two changes in the policy apply to Aetna Commercial Plans. In addition, Aetna Medicare Advantage plans use Aetna Clinical Policies. Please note, Aetna’s Clinical Policy Bulletins are used in conjunction with original Medicare policies. Aetna Medicare Advantage plans may require prior authorization to begin therapy and/or to continue with therapy. Thus, while an order and/or physician signed and dated plan of care may no longer be required, the prior authorization could still be a requirement. If you have questions regarding Aetna Medicare Advantage and these 2 changes, it would be best to contact the plan. The overall policy change—affecting more than 26 million Americans—means patients can now seek treatment from a licensed physical therapist without first visiting a physician or obtaining additional paperwork. It’s a decisive win for patients, physical therapists, and the future of efficient, cost-effective health care.

Plans are beginning to understand that removing administrative barriers helps patients begin treatment sooner, often leading to faster recoveries, less reliance on medication, and a lower likelihood of invasive procedures. As physical therapists know, it’s better for patients and better for the health care system. The policy change took a long time and around a decade of advocacy by APTA. It’s the result of strategic, persistent persuasion. While relationship-building was foundational, a key turning point came when the Centers for Medicare and Medicaid Services (CMS) modified its own plan of care signature requirement for physical therapists.

This national policy shift validated the arguments physical therapists had been making and set a precedent that private payers could follow. What this win also shows is that data alone rarely moves policy. Trust and relationships create the space for meaningful change. In the end, Aetna’s policy change represents a major step toward improving access to care, but it’s also a reminder that sustained advocacy—rooted in collaboration, trust, and evidence—can deliver results that benefit millions. For patients, it means fewer hoops to jump through and quicker access to life-changing care. For physical therapists, it’s a testament to the profession’s ability to shape the future of health care.