A physical therapist (PT) examines you, makes the clinical judgments and writes the plan of care; a physical therapist assistant (PTA) is a state-certified clinician who can deliver parts of that treatment under the PT’s supervision. In Indiana, only the physical therapist may do the initial evaluation, reevaluations and changes to the plan. Who actually treats you on a given day depends on how a practice is staffed, so it is worth asking before you book.
Last reviewed By the Monon Therapy Collective editorial team
What does a physical therapist assistant do during a visit?
A PTA carries out treatment the physical therapist has planned: guiding you through exercises, applying hands-on techniques such as massage and stretching, observing how you respond and documenting it for the supervising therapist. The Bureau of Labor Statistics describes PTAs as working under the direction and supervision of physical therapists.
A good PTA is a skilled clinician, not a helper. Many have years of experience progressing exercise for knee replacement recovery or post-operative shoulders, and patients often see them more often than the therapist. What a PTA cannot do is decide what the problem is or rewrite the plan; those decisions stay with the licensed physical therapist.
What does Indiana law reserve for the physical therapist alone?
Indiana’s physical therapy rules (842 IAC 1-1-1) list the tasks a PTA may not perform: initial patient evaluation, interpreting tests and referrals, initial and ongoing treatment planning, periodic reevaluation, and adjusting the treatment plan. A PTA may administer treatment, including therapeutic exercise and techniques using heat, cold, water, electricity, massage and mechanical devices.
The same rule sets supervision. Unless the physical therapist is on the premises, the PTA must consult with them at least once each working day about all patients’ treatment. For outpatients, the supervising therapist must examine each patient at least every 30 days or every 15 visits, whichever comes first, to review treatment and progress.
- Physical therapist only: evaluation, diagnosis of the movement problem, goals, plan of care, reevaluation, discharge decision.
- PT or PTA: therapeutic exercise, manual techniques, gait and balance training, modalities, home program coaching.
- Aide or technician: setting up equipment, cleaning, moving patients between areas; aides do not provide skilled treatment.
How is a PTA trained compared with a physical therapist?
The training gap is large. A PTA completes an associate degree from an accredited program, typically about two years, and must be licensed or certified by the state after passing an exam; Indiana issues PTAs a certificate rather than a license. A physical therapist completes a bachelor’s degree and then a Doctor of Physical Therapy program, usually three more years, before the national licensing exam.
That difference is mostly in examination and clinical reasoning: the DPT years teach how to work out what is wrong and how to screen for problems that need a physician. Our page on what DPT means covers that degree in detail. PTAs, in turn, often bring deep hands-on experience in one setting, and the two roles are designed to complement each other.
Does it matter whether a PT or a PTA treats me?
For straightforward, well-planned rehab, care from a supervised PTA can work well. It matters more when your problem is changing quickly, when progress has stalled, or when the plan needs frequent clinical decisions, as it often does with complicated back pain, a post-operative protocol with several phases, or symptoms that do not fit a neat pattern.
What tends to matter most is continuity and attention. Seeing a different clinician every visit, or sharing a clinician with several other patients at once, can dilute both. Ask any practice how it is staffed, and our list of questions to ask a physical therapist includes the wording.
- Who will do my evaluation, and who will I see at follow-up visits?
- If a PTA treats me, how often will the physical therapist see me again?
- Will my clinician be working with other patients during my session?
- Who do I contact if something changes between visits?
Who treats you when you are matched through the network in Carmel?
The matching team proposes a licensed physical therapist, an independent practice in Indiana, and that therapist performs your evaluation. Sessions in the FlexWerk suites at Carmel City Center are one-on-one in a closed room, so you are not sharing your clinician’s attention with a second patient.
If having the same physical therapist at every visit matters to you, say so in the matching questionnaire and confirm it with the therapist’s office when you book; the office is the right place to ask how that practice staffs its visits. Our explainer on one-on-one physical therapy describes what that format changes.
Related questions
Can a physical therapist assistant evaluate me?
No. In Indiana the initial evaluation, reevaluations and changes to the plan of care are reserved for the physical therapist. A PTA delivers treatment within that plan.
Are PTAs licensed in Indiana?
Indiana certifies rather than licenses them. A PTA must graduate from an accredited program, pass an exam and hold a certificate from the Indiana Board of Physical Therapy before they can work, and they practise under a physical therapist’s supervision.
Can a PTA discharge me from physical therapy?
No. Deciding that goals are met and writing the discharge summary is part of reevaluation, which Indiana reserves for the physical therapist. A PTA can tell the therapist how your sessions are going.
Why do some clinics use PTAs for most follow-up visits?
Staffing and cost. A practice can see more patients when a physical therapist supervises one or more PTAs, and for steady, predictable rehab that model can work. It is a business choice, and you are entitled to ask about it.
Is a physical therapy aide the same as an assistant?
No. Aides usually have on-the-job training, set up equipment and help with clerical tasks, and they do not provide skilled treatment. A PTA is a state-certified clinician with an associate degree.
Does insurance pay the same for a visit with a PTA?
Not always. Since January 2022 Medicare has paid 85 percent of its usual Part B amount for outpatient therapy services furnished in whole or in part by a PTA, and other payers set their own rules, so ask the therapist’s office if it affects your cost.
Keep reading
- What does a physical therapist do?
- What is one-on-one physical therapy?
- Hospital vs private practice physical therapy: which costs less?
- Post-surgical rehabilitation in Carmel
- How therapists in the network practise
- Tell the matching team what you need
Sources
- Indiana Board of Physical Therapy rules, 842 IAC 1-1-1 (PTA definition and supervision)
- Indiana Code 25-27-1-8 (licensure of physical therapists, certification of physical therapist assistants)
- U.S. Bureau of Labor Statistics: Physical therapist assistants and aides
- U.S. Bureau of Labor Statistics: Physical therapists
- CMS: CY 2022 Medicare Physician Fee Schedule final rule (85 percent payment for services furnished by PTAs, CQ modifier)
- APTA ChoosePT: about physical therapists and physical therapist assistants
This page is general education, not medical advice. A physical therapist can only advise on your situation after an examination.
