Hinge Health, the publicly listed US digital musculoskeletal (MSK) company, grew revenue 51% to 587.9 million dollars in 2025 and then accelerated to 53% growth in Q2 2026, even as only 5% of patients with muscle and joint pain begin treatment with a physical therapist (Hinge Health Q4 2025 and Q2 2026 results; Hinge Health 2026 State of MSK Care Report). The demand pool is enormous: about 1.71 billion people worldwide live with MSK conditions, and US spending on low back and neck pain alone reached an estimated 134.5 billion dollars. Policy is the swing factor: Medicare lets physical therapists deliver telehealth only through December 31, 2027. For the broader virtual care picture, see our telehealth statistics. We aggregated data from the Centers for Medicare and Medicaid Services, the US Bureau of Labor Statistics, the American Physical Therapy Association, the World Health Organization, Hinge Health and Sword Health disclosures, the Peterson Health Technology Institute, and peer-reviewed trials and meta-analyses in Clinical Rehabilitation, npj Digital Medicine, JMIR and Physical Therapy.
TL;DR
- Medicare PT telehealth is authorized only through December 31, 2027; PTs, OTs, SLPs and audiologists lose it on January 1, 2028 (CMS, Telehealth FAQ February 2026).
- Hinge Health 2025 revenue: 587.9 million dollars, +51%; 782,890 members (Hinge Health, Q4 2025 results).
- Hinge Health Q2 2026 revenue: 212.8 million dollars, +53%; 2026 guidance raised to 856 to 860 million dollars (Hinge Health, Q2 2026 results).
- Sword Health has treated 1 million+ patients with AI Care and works with 2,500+ organizations (Sword Health, September 2026).
- 11.5% of US adults with physical therapy visits used telehealth PT in 2023 (Tidwell, MEPS analysis, medRxiv 2025).
- 92% of providers say most MSK patients would benefit from earlier PT, but only 5% of patients started with a PT (Hinge Health, 2026 State of MSK Care Report).
- Real-time telerehabilitation was equivalent to face-to-face care for physical function across 13 studies, n = 1,520 (Cottrell et al., Clinical Rehabilitation 2017).
- Dropout was 15.7% in a digital program vs 34.3% in conventional physiotherapy in a chronic low back pain RCT (npj Digital Medicine 2023).
- A digital PT program was linked to a 58% lower relative risk of surgery vs in-person PT, n = 4,190 (JMIR 2025).
- Hinge reports a 3.0x ROI and 2,941 dollars in MSK savings per member per year across 200,000+ adults (Hinge Health and Howden, June 2026).
- US physical therapist jobs: 283,700 in 2025, median pay 102,760 dollars, 12% projected growth to 2035 (BLS, Occupational Outlook Handbook).
- About 1.71 billion people live with MSK conditions worldwide (WHO, Musculoskeletal health fact sheet).
1. The Demand Problem: Too Much Pain, Too Little Early PT
Virtual physical therapy exists because the conventional pathway leaks. About 1.71 billion people worldwide have musculoskeletal conditions, and these conditions account for approximately two-thirds of all adults in need of rehabilitation (WHO, Musculoskeletal health fact sheet). Low back pain is the single leading cause of disability in 160 countries. In the US, the money follows: an estimated 134.5 billion dollars was spent on low back and neck pain in 2016, with another 129.8 billion dollars on other MSK disorders (Dieleman et al., JAMA 2020).
The bottleneck is sequencing, not supply of evidence. In Hinge Health’s sixth annual survey of 1,000 people with MSK pain and 295 providers, 92% of providers agreed most MSK patients would benefit from earlier physical therapy, yet only 5% of patients started treatment with a PT, and 39% of patients said they skipped non-invasive treatments (Hinge Health, 2026 State of MSK Care Report). That gap between what clinicians recommend and what patients actually do first is the market digital MSK companies sell into.
| Metric | Value | Source |
|---|---|---|
| People with MSK conditions worldwide | About 1.71 billion | WHO, Musculoskeletal health fact sheet (2022) |
| Low back pain prevalence and burden | 570 million people; 7.4% of global years lived with disability | WHO, Musculoskeletal health fact sheet (2022) |
| Share of adults needing rehabilitation due to MSK | About two-thirds | WHO, Musculoskeletal health fact sheet (2022) |
| US spending on low back and neck pain, 2016 | 134.5 billion dollars (57.2% private insurance) | Dieleman et al., JAMA 2020 |
| US spending on other MSK disorders, 2016 | 129.8 billion dollars | Dieleman et al., JAMA 2020 |
| Providers saying most MSK patients need earlier PT | 92% | Hinge Health, 2026 State of MSK Care Report |
| Patients who started treatment with a PT | 5% | Hinge Health, 2026 State of MSK Care Report |
| Patients unsure of next steps during MSK treatment | Over 50% | Hinge Health, 2026 State of MSK Care Report |
Context note: the WHO fact sheet was last updated in 2022 and the JAMA spending estimates cover 2016 (most recent available data: Dieleman et al., JAMA 2020). The Hinge Health survey is a company-commissioned report, useful for direction more than precision. Desk-bound work is one driver of this burden, a theme we track in our workplace ergonomics statistics.
2. Medicare Policy: A Telehealth Benefit With an Expiration Date
For physical therapists, Medicare telehealth is still a temporary permission, renewed in short bursts. Medicare telehealth flexibilities run through December 31, 2027, and starting January 1, 2028 physical therapists, occupational therapists, speech-language pathologists and audiologists can no longer furnish Medicare telehealth services (CMS, Telehealth FAQ updated February 26, 2026). The same document confirms there was a lapse starting October 1, 2025, which CMS says it will treat retroactively as if it had not happened.
That on-off pattern is why the profession wants a permanent fix. APTA has endorsed H.R. 1614, bipartisan legislation that would establish PTs and PTAs as permanent Medicare telehealth providers, and argues that PT telehealth produces good outcomes with little to no patient risk (APTA, Telehealth advocacy). Meanwhile the underlying fee schedule moved: the CY 2026 conversion factor rose to 33.40 dollars for non-qualifying APM practitioners (+3.26%), but CMS also finalized a -2.5% efficiency adjustment for non-time-based codes (CMS, CY 2026 Physician Fee Schedule final rule fact sheet).
| Metric | Value | Source |
|---|---|---|
| Current end date of Medicare telehealth flexibilities | December 31, 2027 | CMS, Telehealth FAQ (February 2026) |
| Date PTs, OTs, SLPs and audiologists lose Medicare telehealth | January 1, 2028 | CMS, Telehealth FAQ (February 2026) |
| Remote institutional therapy billed by hospitals | Ends January 1, 2028 | CMS, Telehealth FAQ (February 2026) |
| Telehealth lapse handled retroactively | From October 1, 2025 | CMS, Telehealth FAQ (February 2026) |
| Bill to make PTs and PTAs permanent telehealth providers | H.R. 1614 (endorsed by APTA) | APTA, Telehealth advocacy page |
| CY 2026 conversion factor (non-qualifying APM) | 33.40 dollars (+3.26%) | CMS, CY 2026 PFS final rule fact sheet |
| CY 2026 efficiency adjustment, non-time-based codes | -2.5% | CMS, CY 2026 PFS final rule fact sheet |
| APTA telerehabilitation guideline | 7 recommendations | APTA, Telehealth advocacy page |
Context note: the extension through 2027 is described by APTA as a two-year extension of pandemic-era Medicare policy. Commercial insurers and Medicaid programs set their own telehealth rules, so the 2028 cliff applies to traditional Medicare billing specifically.
3. Adoption: Telehealth Is a Slice of PT, Not the Default
The usage data are thinner than the hype, and they point the same way: telerehab stuck, but as a minority channel. In 2023, 11.5% of US adults who had physical therapy visits used telehealth PT (1,590 of 13,800 respondents), with higher odds among women and people with more education (Tidwell, 2023 MEPS analysis, medRxiv preprint 2025). The early pandemic baseline was lower: a study of 222,680 outpatient rehab patients found an overall telerehabilitation rate of 6%, falling from 10% to 5% between the second and third quarters of 2020 (Physical Therapy journal, 2021).
Clinician surveys show the same plateau. Among Australian physiotherapists surveyed in late 2023, use jumped from 30% before the pandemic to 94% during restrictions; 82% still offered telerehab afterward, but it made up only 14% of their caseload (JMIR Rehabilitation and Assistive Technologies, 2026). The authors conclude that clinician perceptions, not technology, are now the main barrier. On the patient side, the remaining gap is demographic: education, sex and race all shift the odds of using telePT. The next adoption wave is less about video visits than AI-guided exercise, covered in our AI in healthcare statistics.
| Metric | Value | Source |
|---|---|---|
| US adults with PT visits using telehealth PT, 2023 | 11.5% (1,590 of 13,800) | Tidwell, MEPS 2023 analysis, medRxiv 2025 |
| Female share, telePT users vs non-users | 62% vs 53% | Tidwell, MEPS 2023 analysis, medRxiv 2025 |
| Odds of telePT use, female sex | OR 1.34 (95% CI 1.21-1.51) | Tidwell, MEPS 2023 analysis, medRxiv 2025 |
| Overall telerehab rate, outpatient rehab, 2020 | 6% (10% to 5% from Q2 to Q3) | Physical Therapy journal, 2021 |
| Clinicians who delivered some care via telerehab, 2020 | 37% | Physical Therapy journal, 2021 |
| Australian physios using telerehab: before vs during pandemic | 30% vs 94% | JMIR Rehab and Assistive Technologies, 2026 |
| Australian physios still offering telerehab after restrictions | 82%, but 14% of caseload | JMIR Rehab and Assistive Technologies, 2026 |
Context note: the MEPS figure is a preprint that has not completed peer review, and the 2020 outpatient figure comes from a single outcomes registry (most recent available data: Physical Therapy journal, 2021). No federal series publishes the share of PT visits delivered by telehealth.
4. Clinical Evidence: Comparable Outcomes, Better Retention
The evidence base is now old enough to be boring, which is good news. A 2017 meta-analysis of 13 studies (n = 1,520) found real-time telerehabilitation alone equivalent to face-to-face care for physical function (SMD 0.14, 95% CI -0.10 to 0.37) (Cottrell et al., Clinical Rehabilitation 2017). Later reviews reached similar conclusions: after total knee replacement, telerehab and in-person rehab showed no significant difference in pain or function (Tsang et al., Journal of Telemedicine and Telecare 2024).
Where virtual care pulls ahead is adherence. In a randomized trial for chronic low back pain, dropout was 15.7% in the digital program versus 34.3% in conventional physiotherapy, with no significant difference in disability change (npj Digital Medicine, 2023). The largest single cohort, 10,264 Hinge Health participants, reported a 68.45% average pain improvement at 12 weeks with 73.04% completing into the final month (JMIR, 2020), although an uncontrolled cohort cannot prove causation.
| Metric | Value | Source |
|---|---|---|
| Real-time telerehab vs face-to-face, physical function | Equivalent: SMD 0.14 (95% CI -0.10 to 0.37), 13 studies, n = 1,520 | Cottrell et al., Clinical Rehabilitation 2017 |
| Telerehab vs in-person after knee replacement | Pain SMD -0.15; function SMD -0.04 (not significant), 11 studies, n = 1,825 | Tsang et al., Journal of Telemedicine and Telecare 2024 |
| Telerehab for MSK disorders, trials pooled | 37 trials, 4,288 participants; SMD 0.24 to 0.91 | Molina-Garcia et al., Annals of PRM 2024 |
| Dropout, digital vs conventional physio (low back pain RCT) | 15.7% vs 34.3% | npj Digital Medicine, 2023 |
| Average pain improvement at 12 weeks, 10,264-person cohort | 68.45% | Bailey et al., JMIR 2020 |
| Completers reaching minimally important change in pain | 78.60% | Bailey et al., JMIR 2020 |
| Pain response, AI-supported vs conventional digital care | 64% vs 63%; completion 79.9% vs 70.1% | Journal of Clinical Medicine, 2024 |
Context note: several trials and cohorts here (npj Digital Medicine 2023, JCM 2024, JMIR 2020) were authored by or with digital MSK companies. The independent PHTI assessment concluded in November 2023 that virtual MSK solutions deliver clinically meaningful improvements in pain and function compared with usual care (Peterson Health Technology Institute, Virtual MSK Solutions).
5. The Digital MSK Companies: Hinge Health and Sword at Scale
Virtual physical therapy is now a public-market business with software margins. Hinge Health reported Q2 2026 revenue of 212.8 million dollars, up 53% year over year, with an 86% GAAP gross margin and 43.7 million dollars of GAAP net income (Hinge Health, Q2 2026 results). Guidance tells the momentum story: full-year 2026 revenue guidance started at 732 to 742 million dollars in February and was raised to 856 to 860 million by August. The company says its platform cut human care team hours versus traditional PT by approximately 97% (Hinge Health, Form 10-K for 2025).
Sword Health, still private, reports reach rather than revenue. It says it has treated more than 1 million patients directly with AI Care, serves 2,500+ organizations and has delivered more than 1.5 billion dollars in healthcare savings to date (Sword Health, Sword acquires Headspace, September 2026); it had crossed 13 million AI Care sessions across 55+ countries by June 2026. The Headspace deal pushes MSK platforms into mental health, a market sized in our mental health app statistics.
| Metric | Value | Source |
|---|---|---|
| Hinge Health revenue, FY2025 | 587.9 million dollars (+51%) | Hinge Health, Q4 2025 results |
| Hinge Health members, end of 2025 | 782,890 (+47%); 1.5 million+ since inception | Hinge Health Q4 2025 results; Form 10-K |
| Hinge Health contracted lives | About 25 million (22 million self-insured, 3 million fully insured and Medicare Advantage) | Hinge Health, Form 10-K for 2025 |
| Hinge Health revenue, Q2 2026 | 212.8 million dollars (+53%) | Hinge Health, Q2 2026 results |
| Hinge Health clients, Q2 2026 | 2,929 (+24%) | Hinge Health, Q2 2026 results |
| Hinge Health FY2026 revenue guidance | 856 to 860 million dollars (from 732 to 742 million in February) | Hinge Health, Q2 2026 and Q4 2025 results |
| Sword patients treated directly with AI Care | 1 million+; 2,500+ client organizations | Sword Health, September 2026 |
| Sword AI Care sessions | 10 million (February 2026); 13+ million (June 2026) | Sword Health newsroom, 2026 |
Context note: Hinge Health posted a GAAP net loss of 528.3 million dollars for FY2025, while non-GAAP operating income was 119.5 million dollars (Hinge Health, Q4 2025 results). Hinge is also expanding beyond MSK, agreeing to buy Cylinder Health for 105 million dollars in cash. Sword’s figures are self-reported and unaudited.
6. Cost and Utilization: The Surgery Question
Employers buy digital MSK to avoid the expensive end of the pathway, so surgery and imaging are the numbers that matter. A five-year claims analysis of 200,000+ commercially insured adults, reviewed by benefits consultant Howden, credited Hinge Health with 69% fewer surgeries, 68% fewer imaging scans, a 3.0x ROI and 2,941 dollars in MSK savings per member per year (Hinge Health, June 2026). Avoided surgery accounted for 52% of the savings.
Peer-reviewed comparisons point the same way but with smaller effects. A matched cohort of 4,190 people found a 58% lower relative risk of surgery for a digital PT program versus in-person PT, and knee surgery rates of 9.7% versus 29.5% (JMIR, 2025). An independent meta-analysis found telerehabilitation 89.55 dollars cheaper per individual than conventional treatment (Molina-Garcia et al., Annals of Physical and Rehabilitation Medicine 2024). PHTI’s caution remains relevant: physical therapist-guided solutions can reduce spending, but remote therapeutic monitoring add-ons increase costs.
| Metric | Value | Source |
|---|---|---|
| ROI of Hinge Health program, 2020-2024 | 3.0x (3.14x in 2024) | Hinge Health and Howden, June 2026 |
| MSK cost savings per member per year | 2,941 dollars | Hinge Health and Howden, June 2026 |
| Reductions vs matched controls | 69% fewer surgeries, 61% fewer injections, 68% fewer imaging scans | Hinge Health and Howden, June 2026 |
| Relative risk of surgery, digital vs in-person PT | RR 0.42 (58% lower), n = 4,190 | JMIR, 2025 |
| Knee surgery rate, digital vs conventional | 9.7% vs 29.5% | JMIR, 2025 |
| Telerehab cost vs conventional care | 89.55 dollars cheaper per individual | Molina-Garcia et al., Annals of PRM 2024 |
| Falls among adults 65+, digital program vs control | 37% fewer falls; 57% lower odds of ER visits (n = 687) | Hinge Health via Journal of Comparative Effectiveness Research, July 2026 |
| Sword projected impact in Portugal’s NHS | 97% shorter wait to start treatment; 45% projected state savings | Sword Health, June 2026 |
Context note: the ROI, falls and Portugal figures are company-reported or company-funded, and the Portugal numbers are projections. The JMIR 2025 study was observational, so selection effects cannot be fully excluded.
7. Workforce: The Clinician Constraint Behind the Shift
Telehealth and AI-guided exercise are partly a response to a labor problem. A 2025 microsimulation estimated a shortfall of 12,070 full-time-equivalent physical therapists (5.2%) in 2022, narrowing only to 9,120 FTEs (3.3%) by 2037 (Physical Therapy journal, 2025), the model behind APTA’s Supply and Demand Forecast 2022-2037. The model has supply growing by 39,170 FTEs and demand by 36,280 FTEs from 2022 to 2037, so the gap shrinks slowly but never closes in the forecast window.
The federal outlook confirms steady growth rather than relief. BLS counts 283,700 physical therapist jobs in 2025 at a median wage of 102,760 dollars and projects 12% growth from 2025 to 2035, about 13,400 openings a year (BLS, Occupational Outlook Handbook, Physical Therapists). Physical therapist assistants are growing faster still, at 23% (BLS, Physical Therapist Assistants and Aides). Platforms that stretch each clinician further, like the 2.3-fold rise in PT-to-patient ratio reported with AI support in the Journal of Clinical Medicine (2024), are aimed squarely at this gap. Sensor-based motion tracking used in these programs builds on trends in our wearables statistics.
| Metric | Value | Source |
|---|---|---|
| Physical therapist jobs, 2025 | 283,700 | BLS, Occupational Outlook Handbook |
| Median PT pay, 2025 | 102,760 dollars per year (49.40 dollars per hour) | BLS, Occupational Outlook Handbook |
| Projected PT employment growth, 2025-2035 | 12% (about 13,400 openings per year) | BLS, Occupational Outlook Handbook |
| PTs working in therapist offices vs hospitals | 36% vs 26% (home health 11%) | BLS, Occupational Outlook Handbook |
| PT assistant jobs and growth | 114,100 jobs; +23% to 2035; median pay 68,380 dollars | BLS, PT Assistants and Aides |
| FTE physical therapists, 2022 | 233,890 | Physical Therapy journal, 2025 |
| Projected FTE shortfall | 12,070 (5.2%) in 2022; 9,120 (3.3%) in 2037 | Physical Therapy journal, 2025 |
| PT-to-patient ratio with AI-supported care | 2.3-fold increase | Journal of Clinical Medicine, 2024 |
Context note: BLS job counts and the microsimulation’s FTE counts measure different things (positions vs full-time equivalents), so they should not be compared directly.
Summary: Physical Therapy Telehealth by the Numbers
| Metric | Value | Source |
|---|---|---|
| Medicare PT telehealth end date | December 31, 2027 | CMS, Telehealth FAQ (February 2026) |
| US adults with PT visits using telePT, 2023 | 11.5% | Tidwell, MEPS analysis, medRxiv 2025 |
| Outpatient telerehab rate, 2020 | 6% | Physical Therapy journal, 2021 |
| Australian physios offering telerehab post-pandemic | 82% (14% of caseload) | JMIR Rehab and Assistive Technologies, 2026 |
| People with MSK conditions worldwide | About 1.71 billion | WHO, Musculoskeletal health fact sheet |
| US low back and neck pain spending, 2016 | 134.5 billion dollars | Dieleman et al., JAMA 2020 |
| MSK patients who start with a PT | 5% | Hinge Health, 2026 State of MSK Care Report |
| Telerehab vs face-to-face, function | Equivalent (13 studies, n = 1,520) | Cottrell et al., Clinical Rehabilitation 2017 |
| Dropout, digital vs conventional physio | 15.7% vs 34.3% | npj Digital Medicine, 2023 |
| Hinge Health FY2025 revenue | 587.9 million dollars (+51%) | Hinge Health, Q4 2025 results |
| Hinge Health Q2 2026 revenue | 212.8 million dollars (+53%) | Hinge Health, Q2 2026 results |
| Hinge Health members, end of 2025 | 782,890 | Hinge Health, Q4 2025 results |
| Hinge Health care team hours vs traditional PT | About 97% lower | Hinge Health, Form 10-K for 2025 |
| Sword patients treated with AI Care | 1 million+ | Sword Health, September 2026 |
| Hinge Health ROI (Howden-reviewed) | 3.0x; 2,941 dollars saved per member per year | Hinge Health, June 2026 |
| Surgery risk, digital vs in-person PT | 58% lower | JMIR, 2025 |
| Telerehab cost advantage | 89.55 dollars per individual | Molina-Garcia et al., Annals of PRM 2024 |
| US physical therapist jobs, 2025 | 283,700 (+12% to 2035) | BLS, Occupational Outlook Handbook |
| Projected PT FTE shortfall, 2037 | 9,120 (3.3%) | Physical Therapy journal, 2025 |
Methodology and Sources
Every figure above was read during research for this article in a government page, a peer-reviewed abstract (via Europe PMC), an SEC filing or a company press release. Company-reported figures from Hinge Health and Sword Health are labeled as such, and studies authored or funded by those companies are flagged in context notes. Statistics circulating on blogs without a primary document were excluded.
- Centers for Medicare and Medicaid Services: Telehealth FAQ, updated February 26, 2026, CY 2026 Physician Fee Schedule final rule fact sheet
- American Physical Therapy Association: Telehealth advocacy, Supply and Demand Forecast 2022-2037
- US Bureau of Labor Statistics: Occupational Outlook Handbook, Physical Therapists, Physical Therapist Assistants and Aides
- World Health Organization: Musculoskeletal health fact sheet
- Dieleman et al.: US Health Care Spending by Payer and Health Condition, 1996-2016, JAMA 2020
- Hinge Health: Q2 2026 results, Q1 2026 results, Q4 and FY2025 results, Form 10-K for 2025, 2026 State of MSK Care Report, ROI study with Howden, fall-risk study
- Sword Health newsroom: 10 million AI Care sessions (February 2026), Sword joins Portugal’s NHS (June 2026), Sword acquires Headspace (September 2026), Brazil SUS agreement (September 2026)
- Peterson Health Technology Institute: Virtual Musculoskeletal Solutions assessment (November 2023) and its assessment area brief
- Peer-reviewed studies: Cottrell et al., Clinical Rehabilitation 2017; Tsang et al., Journal of Telemedicine and Telecare 2024; Molina-Garcia et al., Annals of Physical and Rehabilitation Medicine 2024; npj Digital Medicine 2023 low back pain RCT; Bailey et al., JMIR 2020; Journal of Clinical Medicine 2024; JMIR 2025 digital vs in-person PT; Physical Therapy journal 2021, telerehabilitation in outpatient settings; JMIR Rehabilitation and Assistive Technologies 2026, Australian physiotherapy; Physical Therapy journal 2025, supply and demand microsimulation; Tidwell, MEPS 2023 analysis, medRxiv preprint 2025
- Data watch: There is no federal series on the share of PT visits delivered by telehealth; the 11.5% figure is a non-peer-reviewed preprint using 2023 MEPS data and the 6% figure covers 2020 only. Market-research estimates for digital MSK could not be verified (Grand View Research pages were blocked); the PHTI brief cites a Grand View figure of 2.98 billion dollars for the global digital MSK market in 2020 with 27.4% expected annual growth to 2028, which is dated and was not cross-checked against a second firm, so company revenue is used here as the hard market signal. Hinge Health raised its 2026 revenue guidance three times (732 to 742 million in February, 798 to 804 million in May, 818 to 824 million in June, 856 to 860 million in August). The WHO fact sheet dates from 2022 and the JAMA spending data from 2016 (most recent available). The Hinge ROI, falls and survey figures and all Sword figures are company-reported; Sword does not disclose revenue. APTA’s COVID-19 impact report and 2024 hiring benchmark are behind a member login and were not used. The PHTI virtual MSK assessment dates from November 2023 and an update would be expected given the market’s growth.
Last updated: October 3, 2026. We update this roundup quarterly, and the next refresh is expected when Hinge Health reports Q3 2026 results and CMS publishes the CY 2027 Physician Fee Schedule final rule.