What is a Direct Access PT?

A “Direct Access PT” is exactly how it sounds: patients have direct access to physical therapy services without the need for a physician referral or prescription.

As per APTA guidelines, direct access PT means “allowing patients to seek some level of treatment from a licensed physical therapist with no referral or a prescription from a physician.” The definition mentions “some level of treatment”; meaning, there are few restrictions in receiving physical therapy services without having physicians as “gatekeepers”. All 50 states, the District of Columbia, and the US Virgin Islands allow this direct access to physical therapy services to the patients as of January 1, 2015. However, each state has different laws that limit the amount and type of physical therapy services a patient can receive. (Many states continue to impose arbitrary restrictions on direct access, or only allow for treatment without referral under very limited circumstances.)

Stark Law: This is a set of United States federal laws under which physician self-referral is not permitted. This law requires “referral” by a physician to access or provide health care services. Sections I & II of the stark law was designed to control self-referrals. The term, “self-referral” means a physician’s referral is not mandated to access health care services.

Types Restrictions to PT Services without a Referral:

Restrictions in direct access PT guidelines are as follows:

• Unrestricted Access: As the word suggests, there are no restrictions to access physical therapy services. There are a total of 18 states in the US that allow unrestricted access to physical therapy services.
• Patient Access with Provision: There are 26 states, DC, & US Virgin Islands that allow access to evaluate and treat with some provisions or restrictions. Examples of restrictions include limits on the numbers of visits or limits on visit time.
• Limited Access: This means that access to physical therapy services are limited to evaluation only. Or, it may be limited to treatment of certain patient populations or under certain diagnoses. There are 6 states with limited patient access to physical therapy services.

View Direct Access PT Guidelines Per State

What Can Physical Therapists Do?

If you are a physical therapist interested in direct access PT services, check your state guidelines by clicking the link above. You can provide education and awareness to your patients to market your practice. Your patients will have family and social circles who may need PT services. By educating them about their ability to directly access you (PT) without a doctor’s prescription, you can alleviate a lot of mental stress off of a patient for co-pays and long waits for a physician’s visit. Also, you may have to refer your patients to a physician or an orthopedic surgeon. By referring your patient, you can develop and improve your relationship with the physicians. Chances are that physician will start referring you his/her patients in return. A win-win on both sides!

Continuing Education for Direct Access PTs

Many state PT boards require direct access continuing education to include CEUs on the topics of evaluative procedures and differential diagnoses. To view direct access CEUs, click here.

Resources Here are a few resources that can help you find out more about direct access PT.

1. http://www.apta.org/StateIssues/DirectAccess/
2. https://www.apta.org/your-practice/practice-models-and-settings/direct-access