Background/Purpose: The purpose of this study was to investigate physical educators' self-reported use, understanding, and confidence with game-based approaches (GBAs) in their K-12 physical education programs. Method: A survey of New York State physical education professionals was conducted that yielded quantitative data on how they used game-based approaches. Data were analyzed using Observation Oriented Modeling (version 5.4.2022), a tool well suited for survey data, especially teachers' reports of game-based lesson sequences. Results: Physical educators reported both awareness and confidence with various GBAs spending most physical education game-based lessons teaching invasion games with emphasis on the psychomotor domain. Respondents' typical game lesson sequences did not match model GBA lesson sequences. Conclusions: Findings from this study indicate respondents do not use GBAs for their game-based lessons. Beyond teacher preparation, intentional professional development should address conceptual, pedagogical, cultural, and political obstacles, and may help practitioners become more pedagogically fluent with GBAs.