Physical Therapy Liability Claim Costs Rose 20.3%
Clinic owners and therapists must adjust risk management as claim severity and costs for manual therapy rise.
Updated on Sept. 29, 2026 in Nursing Jobs
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Professional liability claim costs for physical therapists climbed 20.3% according to a new report from HPSO and CNA. The analysis of 497 closed claims highlights mounting financial exposure for practices utilizing manual therapy and dry needling.
Why it matters
Rising claim severity and higher-cost settlements for manual therapy and fracture-related injuries directly inflate professional liability insurance premiums for independent practices. Operators must now evaluate if their current risk mitigation strategies are sufficient to address these shifting loss profiles.
The study of 497 closed claims found that practice-level liability claims average $170,418, while licensure defense payments have increased 14.8% since 2020. Notably, high-cost claims between $250,000 and $749,999 rose to 13.7% of the total, up from 9.3% in previous periods.
The players
HPSO
A provider of professional liability insurance coverage for healthcare professionals.
CNA
A global commercial insurance writer providing coverage for business and professional liability.
The details
Liability costs are increasingly tied to manual procedures, with manual therapy claims showing a 35.6% cost increase. Dry needling now accounts for 26.4% of all manual therapy claims, while fractures represent 24.2% of all injuries reported. These costs are exacerbated by the fact that claims involving physical therapist assistants are 40.4% more expensive on average than those involving the primary therapists themselves.
Timeline
January 1, 2020: Dataset period begins for claims analysis.
December 31, 2025: Dataset period ends for claims analysis.
September 29, 2026: Report on professional liability claims was published.
Coming months: Release of series of seven Physical Therapist Spotlights scheduled.
Market Landscape
This data marks a significant upward shift from the risk landscape defined by the 2020 baseline for healthcare professional liability trends. The findings mirror broader industry cycles where technical skill sets, such as manual therapy, attract increased scrutiny and higher defense costs.
Practice owners should immediately review their professional liability policy limits to ensure coverage accounts for the 20.3% increase in total incurred claim costs. Management should also prioritize auditing documentation practices for manual therapy and dry needling to mitigate fracture-related litigation risks.
The takeaway
The rise in high-value claims indicates that manual therapy and dry needling carry disproportionate liability risks for modern practices. Operators should track the upcoming Physical Therapist Spotlights for deeper analysis on specific clinical areas that are currently triggering the largest indemnity payments.
Further reading
For broader trends in clinical employment risks, visit Nursing Jobs.
More information
To review the full data on loss frequency and severity, Download professional liability claim report.
Source note: This article includes information reported by Physical Therapy Products.
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