For decades, Medical Exercise Training (MET) existed in the gray zone between therapy and fitness—important work, but often unrecognized by healthcare and insurers. That’s changing.

Insurance carriers are now open to reimbursing MET services—but only when documentation, CPT coding, and professional ethics align. This is where many MedExPROs fail: they want medical recognition but operate with fitness-level documentation.

CPT Codes: The Language of Legitimacy

CPT codes are the language of healthcare billing. For Medical Exercise Professionals, they don’t represent treatment—they represent structured, medically necessary exercise.

The core MET codes include:

• 97110 – Therapeutic Exercise: Progressive strength and mobility work
• 97112 – Neuromuscular Re-education: Balance, coordination, motor control
• 97530 – Therapeutic Activities: Functional movements that improve ADL performance

Each session must justify the use of these codes with measurable outcomes and a written referral. W...

You’ve earned your credentials. You know how to assess, design, and progress exercise safely for clients with medical conditions. But let’s be honest — great sessions alone don’t build great businesses.
At this stage of your MedExPRO journey, you’re not just managing clients… you’re managing a practice. That requires a different skill set — one built around systems, communication, and predictable revenue.

This post recently appeared in the Business Tier of the MES Network — the place where you learn to run your practice like a business, not a hobby.

1. The Shift in Mindset: From Sessions to Systems

Every successful MedExPRO eventually reaches the same turning point: “I’m good at what I do, but I’m tired of chasing clients.”
This tier teaches you how to make your business run on systems, not sweat.

Start with clarity:

• Who are your top three referral sources — or who should they be?
• What are your top three measurable business goals (monthly revenue, referrals, retention)?
• What
...

Most fitness and rehab professionals look at grip strength as a measure of hand or forearm endurance. But what if I told you your client’s hand strength might be the window into their brain’s health?

1. Grip Strength Is More Than Muscle

Research from multiple gerontology journals has confirmed it:

Lower grip strength is consistently linked to faster cognitive decline, memory loss, and a higher risk of dementia.

Every 5-kilogram drop in grip strength can raise dementia risk by as much as 15–25%.
Why? Because grip strength isn’t just a mechanical output — it’s a neurological signature.

When a client squeezes that dynamometer, you’re not just testing muscle fibers; you’re measuring the efficiency of the nervous system, the integrity of neural pathways, and even cerebral vascular health.

2. The Neurological Connection

The correlation runs deep:

• The prefrontal cortex governs both fine-motor control and executive function.
• Vascular insufficiency limits oxygen delivery to both
...

Introduction: Beyond the Title

Becoming certified as a “Medical Exercise Specialist” is a significant step — but it’s not the destination.
Many professionals stop at the certification, believing a credential automatically makes them a medical exercise professional. But a title alone doesn’t make you a MedExPRO. It’s not just what you know — it’s how you think, document, communicate, and deliver outcomes that healthcare understands.

This is the difference between a fitness trainer with a certification for medical conditions and a true Medical Exercise Professional.
One has information. The other has infrastructure — systems, documentation, communication, and a mindset rooted in professionalism.

1. The Fitness Origin: Where Most Begin

Most MedExPROs start as personal trainers. Their early success comes from helping clients lose weight, build strength, or improve mobility.
But as clients age and medical conditions increase — hypertension, diabetes, joint replacements, balance defici...

The MedExPRO Crossroads

If you’ve been in the health and fitness industry for 3–5 years, chances are you’ve worked hard to develop client trust, achieve esthetic goals, and keep people motivated. But you’ve also noticed something: the future of your profession isn’t in six-packs or PR lifts—it’s in outcomes that matter to healthcare.

Clients are living longer with chronic conditions, managing multiple diagnoses, and often leaving physical therapy or medical care without clear next steps. This is where Medical Exercise Training (MET) steps in, and where you, as a MedExPRO must evolve.

Transitioning from a personal training business to a true Medical Exercise Training practice requires more than passion. It requires systems, standards, and communication that meet the expectations of physicians, therapists, and insurance carriers. This article outlines the roadmap.

Step 1: Shift Your Professional Identity

Most fitness professionals start by selling workouts and sessions. MedExPROs mu...

In Tip #43 of the MET 101 series, Dr. Mike highlights an often-overlooked but incredibly effective strategy for building a thriving medical exercise practice: creating referral relationships with massage therapists and naturopaths. While many MedExPROs focus only on physical therapists, chiropractors, and physicians, this tip expands your network—and your impact.

Naturopaths are especially valuable when working with clients dealing with immune dysfunction or gastrointestinal disorders, two areas often underserved in conventional settings. Dr. Mike points to Glenn Gerald, an MES and naturopath in New Jersey, as an excellent example of the power of combining these disciplines. He encourages every MedExPRO to identify a trusted naturopath in their area and begin exploring partnership opportunities.

Massage therapists, on the other hand, are an ideal complement for clients suffering from chronic pain, such as arthritis, spinal issues, or failed back surgery syndrome. Dr. Mike strongly re...

Introduction: From Emerging Role to Essential Profession

The Medical Exercise Specialist (MedExPRO) is no longer a nice-to-have. You are becoming indispensable in the healthcare system. With aging populations, soaring chronic disease rates, and shortened rehab episodes driven by insurance limits, the gap between discharge from therapy and long-term independence is wider than ever.

Fitness alone cannot close this gap. Rehabilitation is too brief to sustain it. That leaves the MedExPRO standing squarely in the middle—the only professional uniquely trained to extend the continuum of care, manage function, and restore independence.

The big question is no longer “Is there a role for MedExPROs?” It’s “How soon will the healthcare system catch up to what MedExPROs already know—and will you be ready when it does?”

Jodie Hicks: A Case Study in Today’s Reality and Tomorrow’s Future

Jodie Today

At age 56, Jodie Hicks was discharged from physical therapy after rotator cuff surgery. Insurance...

Building a steady stream of medical referrals is the cornerstone of a thriving Medical Exercise Training practice. As a MedExPRO, your credibility and growth hinge not just on exercise knowledge but on how well you communicate with physicians, therapists, and chiropractors. Too many professionals fall into the trap of silence—avoiding outreach or documentation out of fear of “not knowing enough.” The reality is, medical providers don’t expect you to diagnose or treat—they expect you to be the expert in exercise. By mastering a clear, systematic referral process, you elevate yourself from “just a trainer” to a trusted colleague in the medical community.

Step 1. Make the First Contact – With Professional Clarity

• Use the introductory letters (physician, PT, chiropractor versions) as your foundation.
• Clearly define your role as a MedExPRO: non-clinical, outcome-focused, complementary.
• Attach a one-page service overview and sample documentation.
• Follow up within 5–7 days by phone or
...

For 32 years, I’ve watched the fitness industry package hope into certifications. A weekend course, an online test, or a shiny new title promises to transform a personal trainer into a professional capable of managing clients with medical conditions. The illusion is powerful. Fitness professionals invest thousands chasing letters after their names, believing the more acronyms they collect, the more competent they become.

Please, do not think I or the Medical Exercise Training Institute is exempt from this situation. Our Medical Exercise Specialist certification has been in existence 32 years, and we’ve certified thousands of fitness professionals. So, I am complicit in this perpetuation of certification of competence. We are also guilty. 

But here’s the truth most don’t want to hear: certifications give the allure of competence, not the reality of it.

Competence in medical exercise training doesn’t come from passing an exam. It comes from consistent, structured practice. It comes fr...

Closing the Gap After Therapy -  A Step-by-Step Guide for MedExPROs

For decades, physicians have relied on physical therapy, surgery, or medication as the “next step” after injury or illness. But when those interventions end, many patients are left with lingering deficits—trouble climbing stairs, stiffness in their shoulders, difficulty with daily tasks. They’re discharged from therapy, but not restored to full function.

This is the gap that Medical Exercise Training fills. And it’s where you—the Medical Exercise Professional (MedExPRO)—become essential.

Your job is NOT to treat or diagnose, but to provide safe, progressive exercise programming that helps clients regain full function after therapy. But here’s the challenge: most physicians have never worked with a MedExPRO. They don’t know you exist—yet.

That means it’s up to you to make the introduction. And yes, that can feel intimidating. Many MedExPROs hesitate because they worry:

• What if the doctor brushes me off?
• What if ...