FOR IMMEDIATE RELEASE
Physical Therapists Challenge Discriminatory Medicare Rule That Bars Private-Pay Arrangements
Washington, D.C. – August 13, 2025 — In a bold legal move to protect both patient choice and the viability of independent practice, Dr. Sean Wells, PT, and the United Physical Therapy Association (UPTA) have filed a federal lawsuit against the U.S. government challenging Medicare’s blanket ban on private-pay arrangements for physical therapists.
The case, Sean Wells and United Physical Therapy Association v. Robert F. Kennedy, alleges that the existing rule violates the Fifth Amendment’s Equal Protection and Due Process Clauses, and exceeds Congress’s authority under the Commerce Clause.
“Physical therapists are categorically banned from ‘opting out’ of Medicare and serving enrollees on a cash basis,” said Pacific Legal Foundation attorney Joshua Polk. “Meanwhile, dietitians, social workers, and marriage counselors can freely contract privately with beneficiaries who want to pay out-of-pocket. This arbitrary exclusion serves no legitimate purpose except to trap providers and patients in a broken system.”
The Current Problem: An Unequal and Unsustainable System
Under existing law, physicians, psychologists, and many other healthcare providers are permitted to opt out of Medicare and offer private-pay options to patients. But physical therapists are uniquely singled out—prevented from contracting privately with Medicare beneficiaries, even when those patients are willing and able to pay out-of-pocket.
This forces PTs like Dr. Wells, who runs a mobile physical therapy practice in Florida, to turn away patients simply because they’ve aged into Medicare. It’s a policy that punishes patients for growing older and penalizes providers for seeking sustainable care models.
UPTA: Leading the Charge for Change
With legislative efforts repeatedly failing, the United Physical Therapy Association, a clinician-led nonprofit formed in 2024, is now pursuing change through the courts. UPTA believes that the opt-out ban:
- Violates constitutional protections of equal treatment and due process
- Discriminates against PTs compared to other doctoral-level healthcare providers
- Limits patient choice, particularly in underserved and rural areas
- Cripples innovation, restricting clinics to outdated care models
- Jeopardizes clinic viability, especially for those offering specialty or concierge services
“This lawsuit is not about turning our backs on Medicare—it’s about ensuring our profession survives long enough to keep serving Medicare patients,” said Scott Gardner, PT, DPT, President of UPTA. “We are fighting for fairness, autonomy, and the right to innovate—just like any other provider.”
What’s at Stake
Clinic Survival – Opt-out restores financial sustainability for independent clinics burdened by stagnant reimbursement and rising costs.
Care Innovation – Cash-based and hybrid models can flourish outside rigid Medicare constraints.
Professional Equality – Physical therapists can reclaim their rightful place as autonomous, doctoral-level providers.
Patient Freedom – Medicare beneficiaries should have the right to choose their provider—even if that means paying privately.
About the Case
Filed with support from the Pacific Legal Foundation, the lawsuit challenges the government’s outdated classification of PTs as “ancillary providers” tethered to physician oversight and unfair policy decisions. If successful, the case could rewrite the future of the profession—allowing physical therapists to serve Medicare beneficiaries on their own terms.
Read the full case: https://pacificlegal.org/case/cms-medicare-physical-therapist-discrimination/
Learn more: www.unitedpta.org
Media Contact:
Scott Gardner
scott.gardner@unitedpta.org
443-235-8506
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