{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/physical-therapist-assistants/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Physical Therapist Assistants",
    "soc_code": "31-2021",
    "category": "Healthcare Support",
    "us_employment": 112430,
    "median_annual_wage": 68380
  },
  "verdict": "SAFE",
  "risk_resistance": 79,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 16,
    "embodiment": 19,
    "liability_shield": 13,
    "trust_premium": 16,
    "judgment_accountability": 15
  },
  "reasoning": {
    "task_resistance": "Manual muscle testing, hands-on joint mobilization, spotting a post-op TKA patient through parallel bars, and cueing a hemiplegic patient's weight shift all require real-time tactile feedback and body-to-body contact, leaving only note templating and HEP printouts on the automatable side — which is why this sits at 16 rather than the low teens of jobs with heavy screen-based charting loads.",
    "embodiment": "A PTA spends the shift in gait belts, transferring patients from wheelchair to mat table, applying ultrasound and e-stim to skin, kneeling on clinic floors and navigating cluttered home-health bedrooms and SNF hallways — uncontrolled, unpredictable environments where the patient may buckle mid-step, and the only points off 20 are for the documentation hours.",
    "liability_shield": "Licensure or certification is mandated in nearly all states with continuing-education and jurisprudence requirements, and a PTA can lose that license for treating outside the plan of care — but the evaluation, diagnosis, POC, and discharge decision legally belong to the supervising PT, which caps this below the 17-20 range of independently licensed practitioners.",
    "trust_premium": "Patients see the PTA far more often than the PT — three visits a week for six weeks of painful progressive loading — and adherence depends on whether they believe this specific person when told the discomfort is safe; the relationship is a real part of the outcome, though the referral and payer relationship still runs through the PT and physician.",
    "judgment_accountability": "Within a session the PTA decides whether to progress resistance, hold back on a patient whose knee is hot and swollen, stop for a blood-pressure or dizziness red flag, and escalate to the PT — real unsupervised calls with patient-safety consequences."
  },
  "rationale": "The core of the job is physically guiding bodies — manual therapy, gait training, transfers, therapeutic exercise, modality application — with a patient who is in pain, frightened, or deconditioned, and none of that digitizes. PTAs are licensed or certified in nearly every state and work under a PT's plan of care, so a credentialed human must deliver and document the treatment. The automatable slice is real but thin: progress note drafting, exercise-program handouts, insurance documentation, and scheduling.",
  "outlook": "Demand grows with the aging population; expect app-based home exercise and AI documentation to absorb the low-acuity and paperwork slices while hands-on complex care keeps expanding.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "CMS therapy billing rules already require that services be furnished by a licensed therapist or a PTA under supervision; a tightening of the Medicare Part B supervision standard (e.g. reverting the private-practice requirement to direct rather than general supervision, or explicitly barring billing for any exercise session delivered by an app or unlicensed aide without an on-site PTA) would push this up. Also state practice-act amendments defining 'therapeutic exercise delivery' as a licensed act that telehealth/remote-monitoring vendors cannot substitute.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "judgment_accountability",
        "change": "If state boards and APTA scope guidance formalize the PTA's duty to halt or modify treatment on adverse response and to escalate to the PT — with documented board discipline for failure to do so — the role's ownership of in-session safety calls (post-op precautions, orthostatic events, red-flag referral) becomes an accountable one rather than a delegated task.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "Genuine two-tier job: if AI documentation (Netsmart/WebPT ambient note tools), HEP handout generation, and prior-auth paperwork are fully absorbed, the residual day is nearly all hands-on progression, cueing, and patient-response reading. Task-mix shift alone raises resistance without any new law.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "Narrow route only: if payers or employers begin marketing remote-monitored app-based rehab (Hinge Health, Sword Health) as the default and outcomes for post-surgical or elderly patients diverge, orthopedic surgeons' referral preferences for in-person hands-on treatment become an explicit purchased preference. Weak lever — most PTA demand is payer-directed, not patient-chosen.",
        "plausibility": "plausible",
        "would_add": 1
      }
    ],
    "ceiling_note": "Already near ceiling on embodiment (19) and task_resistance (16); realistic headroom is a few points in liability_shield and judgment_accountability. The real downside risk is not automation but substitution by lower-cost app-based rehab benefits and by unlicensed aides where supervision rules loosen — a scope/reimbursement fight, not a capability one."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 90170,
        "wage": 57430
      },
      {
        "y": 2018,
        "emp": 94250,
        "wage": 58040
      },
      {
        "y": 2019,
        "emp": 96840,
        "wage": 58790
      },
      {
        "y": 2020,
        "emp": 92740,
        "wage": 59770
      },
      {
        "y": 2021,
        "emp": 93660,
        "wage": 61180
      },
      {
        "y": 2022,
        "emp": 97740,
        "wage": 62770
      },
      {
        "y": 2023,
        "emp": 104000,
        "wage": 64080
      },
      {
        "y": 2024,
        "emp": 108010,
        "wage": 65510
      },
      {
        "y": 2025,
        "emp": 112430,
        "wage": 68380
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 24.7,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}