Summary: A new HPSO/CNA report finds that professional liability claim costs for physical therapy professionals have risen significantly, highlighting growing risks related to manual therapy, monitoring, injuries, practice-level claims, and licensure defense.

Key Takeaways:

  • Claim costs are rising: Average total incurred increased 20.3% to $162,174, while higher-value claims of $250,000–$749,999 grew from 9.3% to 13.7%.
  • Manual therapy remains a major risk: Improper manual therapy is the most common PT claim allegation, with average costs up 35.6% since 2020; dry needling accounts for 26.4% of these claims.
  • PTAs and practices face notable exposures: PTA claims are less frequent but 40.4% more costly on average, while practice-level claims average $170,418 compared with $147,655 for individually insured professionals.

The average total incurred for professional liability claims involving physical therapy professionals has increased 20.3% to $162,174, with the share of claims closing in the $250,000 to $749,999 indemnity range rising from 9.3% to 13.7% since the 2020 dataset, according to the newly released Physical Therapy Professional Liability Claim Report: 5th Edition. Published by Healthcare Providers Service Organization (HPSO), part of the Healthcare division of Aon Affinity, the affinity business of Aon plc (NYSE: AON), and CNA (NYSE: CNA), the report highlights professional liability exposures facing physical therapy professionals and practices, including claim trends and licensure defense matters, as well as case studies, analysis and risk management insights.

“Physical therapy professionals are committed to delivering safe, effective care that helps patients function at their best; however, they practice in an environment marked by increasing complexity and evolving risks,” said Jennifer Flynn, vice president of risk management for Healthcare Providers Service Organization. “This report is designed to provide physical therapists, physical therapist assistants, and practice owners with insights and strategies to help minimize their unique professional liability exposures.”

Other key report findings reveal: 

  • Physical therapy practices face higher claim costs. Physical therapy practices experienced a 15.4% higher average total incurred than individually insured physical therapists, physical therapist assistants and physical therapy students ($170,418 versus $147,655).
  • Physical therapist assistant claims are less frequent, but more costly. While physical therapist assistants comprise a smaller portion of total claims (16.5%) compared to physical therapists (76.5%), claims asserted against them are 40.4% more costly on average ($208,546 versus $148,507).
    • The distribution of physical therapist assistant claims related to failure to monitor is almost double that of physical therapist claims for the same allegation, and the average total incurred is 47.4% more than the average total incurred for physical therapists ($291,613 versus $197,783).
  • Manual therapy remains a key claim driver. Improper performance of manual therapy is the most common physical therapist claim allegation, with an increase in average total incurred of 35.6% since 2020 ($161,317 in 2026 versus $118,957 in 2020), with dry needling accounting for 26.4% of these claims.
  • Fractures are the most frequent injury. Fractures represent the most frequent injury type associated with physical therapist claims, accounting for 24.2% of all physical therapist claim injuries, and with an average total incurred of $179,484.
  • Licensure defense costs are rising. The average payment for licensure defense expenses in the 2026 dataset increased 14.8% compared to the 2020 dataset ($7,369 in 2026 versus $6,420 in 2020).

“By understanding the factors that lead to claims, physical therapy professionals and practices can take proactive steps to help reduce risk and lower the chance of litigation,” said Crystal Miller, RPLU, CPCU, underwriting director at CNA. “This report aims to raise awareness of trends and claim drivers to enhance risk management knowledge and support safer care for physical therapy professionals and their patients.”

In the coming months, HPSO will release a series of seven Physical Therapist Spotlights with links to resources that highlight risk control best practices on topics such as documentation, licensure defense, and emerging technology.

The Physical Therapy Professional Liability Claim Report: 5th Edition is published by CNA and HPSO and represents an ongoing commitment to educating physical therapy professionals. The general analysis includes 497 closed professional liability claims involving physical therapists, physical therapist assistants, physical therapy practices and other healthcare practitioners providing services as employees of an insured physical therapy practice between January 1, 2020 and December 31, 2025, that resulted in an indemnity payment of $10,000 or greater (the 2026 dataset).1 

To download the complete report, please visit https://www.hpso.com/ptclaimreport.

1See report for limitations and considerations.