Physical therapy benchmarks

physical therapy benchmarks, physical therapy benchmark

Physical therapy benchmarks are an ever-growing requirement for proving that a patient’s care is medically necessary. Part of documenting the benefit and necessity of our services involves setting physical therapy benchmarks for our clients, then regularly assessing the client’s progress as it relates to those benchmarks.

At first glance this may seem like just an insurance-driven protocol that PTs must follow without question. In this article, though, you are going to see why setting physical therapy benchmarks is important beyond helping you to get paid for each visit and you will learn some helpful tips for selecting appropriate benchmarks.

What is a physical therapy benchmark?

Generally defined, a benchmark is a standard or point of reference against which something can be compared or assessed. Benchmarks exist in just about every industry as a metric of performance or success. Physical therapists use benchmarks all the time, even if they do not realize it. Let’s take a look at some examples of benchmarks in physical therapy:

Visit count benchmarks: Some clinics will establish visit count benchmarks for different diagnoses. In this scenario therapists aim to help their patients achieve readiness for discharge by a certain number of visits. Some conditions may have longer benchmarks and others, shorter.

Subjective benchmarks: Physical therapists aim to make their clients feel better. Subjective benchmarks are typically based on the results of a subjective outcome measure such as the Neck Disability Index, the Numerical Pain Index or the Activities Specific Balance Confidence Scale. In this case, the benchmark is based on the patient’s perception of their symptoms or function. 

Objective benchmarks: Objective benchmarks are based on the results of an objective outcome measure or on a functional impairment, activity or participation restriction. These benchmarks are meant to be rooted in objective data collected about a patient’s presentation or performance. Examples of this type of benchmark may be manual muscle test scores, number of falls in a time period, or scores on the Functional Gait Assessment or single leg hop for distance. 

Objective outcome measures are required in many cases for insurance to cover physical therapy services. 

Pros and cons for physical therapy benchmarks

Before discussing strategies for selecting the best benchmarks, it helps to consider the pros and cons for using benchmarks in physical therapy. As you will see, the pros outweigh the cons and provide some good justification for why you should utilize these in your practice. 

Pros of using physical therapy benchmarks
  • Efficient utilization of resources: An argument for setting visit count benchmarks is to challenge therapists to give the best care in the most efficient way possible. To do this in the most ethical way, a therapist should aim to elevate their skills through practice and continuing education so that their patients can reach their goals faster. 

  • Determine functional impact of symptoms: One way in which physical therapists communicate medical necessity of services is by explaining how a patient’s symptoms are impacting their function. Using outcome measures that quantify functional implications, such as the Dizziness Handicap Inventory or the Oswestry, help therapists to understand how their patients’ symptoms impact their daily life. 

  • Helps goal setting: Setting timely and functional goals (ie. benchmarks) is a necessary part of every plan of care. Utilizing outcome measures can help you set appropriate and meaningful goals for them. If you know, for example, that a given score on a sport-specific outcome measure is associated with lower injury recurrence, this will help you know where to set your goals for this patient.

  • Motivate the patient to be an active participant in their plan of care: When you involve patients in the creation or identification of personal benchmarks, they often become more invested and motivated in their care. Having goals to work toward can motivate them to follow the plan of care as well as to better understand your recommendations for activity restrictions or discharge.

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Cons of using benchmarks
  • Visit count benchmarks can promote substandard care: While under the right circumstances visit count benchmarks can inspire therapists to become better at their jobs, under the wrong circumstances therapists may feel pressured to discharge patients too early or to keep them longer than is necessary. 

  • Outcome measures have limitations: Outcome measures have psychometric data that quantifies how useful, reliable and precise the results will be under a given circumstance. That being said, you may find that available outcome measures are not perfect for measuring a specific patient’s impairments or function. Sometimes patient perception or cognition can skew the results of a subjective outcome measure. Other times it is difficult to find an outcome measure that was studied in your patient's population or that is appropriate to their level of function, which then limits the feasibility of those outcome measure benchmarks. In these cases, you may have to rely on functional goals unrelated to standardized outcome measures. 

How to select appropriate physical therapy benchmarks
  • Visit count benchmarks: Visit count benchmarks need to be implemented judiciously to prevent over or under-treating patients. Collecting historical data over a number of months/years for a given diagnosis or patient population can give an idea of what benchmark is realistic. Working as a team to ensure understanding of readiness for discharge can also help ensure patients are not discharged too soon or kept on the caseload longer than necessary.

  • Subjective and objective benchmarks: When selecting outcome measures and functional metrics to establish subjective and objective benchmarks, there are several things a therapist should take into consideration:
    • Is the outcome measure validated for use in that patient population or for that body area?
    • What is the psychometric data (ie. interrater reliability, specificity, cut-off scores etc.)
    • Do your goals reflect functional impairments important to the patient?
    • How does the content of that measure or goal relate to the patient’s actual life and the functional areas that are impaired? Are there cut-off scores that can be utilized to.

As you can see, when done right, there are many benefits to using physical therapy benchmarks. While every patient-interaction is different, physical therapy benchmarks can help make your treatments more meaningful and effective when taking into consideration the functional impairments and goals of your clients.


Keeping track of physical therapy benchmarks may sound difficult but having the right system can make it simple. Consider using a comprehensive electronic health record (EHR), practice management and teletherapy tool like Theraplatform, to ease some of your worry. They offer a 30-day trial with no credit card required. Cancel anytime.

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