My endgame builds uses 13 bound skills and I use a slot for push to move.

Is there really no way to just bind "push to move" in the options somewhere like every other game that has this feature, instead of having it take up a skill slot? Ideally I could have W as push to move and then use all 13 skills on my bar. If not I'm going to have to drop a skill tbh, I'm not ditching push to move, even if it makes me suboptimal in endgame.

Also wouldn't be a problem if the game had WASD.

No matter how many skills I have allocated to use, I always and only use my LMB for "Move only". It might take a bit of getting used to for you compared to WASD, but I have never had a problem with it.

Are any of your skills able to make use of Automation support, or CWDT etc?

I have found that for like the passives, I am supposed to run two Heralds, Tempest Shield and I think Determination? But they don't need to be bound to seperate buttons, when I need to rebuff them I can add them to the same key one by one to get them back up. I don't remember what made me need to rebuff but I think I've only had to do it once so far. So that will free up some space. I got used to having W as push to move since Diablo III, and I prefer it for kind of "sharing the load" for clicks between two hands. I kind of have a longevity obsession these days lol. I remember having long sessions of Diablo II when younger and having to click so much with right hand, well I doubt it was RSI at that age but then you go to play guitar or something and your hand is tired. haha.

Also no, looking at my build guide, no automation skills, I guess I could tweak it but I have to assume that would make me lose some power. We aren't at endgame yet though, finishing Act 7.