Direct Access to Physical Therapy Services: Overview

The Problem

While state law generally allows patients to seek evaluation and treatment from a licensed physical therapist without a prescription or referral from a physician, patients are limited in their ability to do so in many states by arbitrary and unnecessary restrictions. These restrictions are typically in the form of time and visit limits, previous diagnosis requirements, limited patient populations, or requiring a referral for certain types of treatment. These restrictions do not recognize the professional training and expertise of the licensed physical therapist nor do they serve the needs of those patients who require physical therapy but whose care is unnecessarily interrupted by these restrictions..

The Solution

Amend current statutes at the state level to remove arbitrary limitations on direct access to physical therapy services.


In the age of health care reform, state legislatures continue to seek solutions that will expand access to the health care services the citizens of their state need while also addressing the growth in health care costs. One of the most effective tools for cost control and increased access is easily attainable yet often overlooked and underutilized by the legislatures - that of direct access to the services of nonphysician health care professionals.

Physical therapy is the case in point. Entry into the profession and practice of the profession are stringently regulated by all states, and as highly trained health care professionals, physical therapists have a proven track record of effectively treating millions of patients. Physical therapists are well-qualified, both through formal education and clinical training, to evaluate a patient's condition, assess his or her physical therapy needs and, if appropriate, safely and effectively treat the patient. Physical therapists are also well-qualified to recognize when patients demonstrate conditions, signs and symptoms that should be evaluated by other health care professionals before therapy is instituted. Physical therapists recognize when it is appropriate to refer patients to these other health care professionals for consultation.

Every state, the District of Columbia, and the US Virgin Islands have all recognized the safety and benefits of direct access to physical therapy by removing from their statutes, all or some of the referral requirements or provisions for a physical therapy evaluation and treatment. However, if your state laws continue to include out-dated and unnecessary barriers to direct patient care by physical therapists, please consider the benefits of reform. By amending the physical therapy practice act in your state, you will be providing your constituents with an additional entry point into the traditional medical system, increased choice in the selection of a health care professional, access to less expensive and more timely care, and a simple, yet, extremely effective way to meet the goals of increased access and cost containment.

For additional information on direct access, please contact APTA's state government affairs department at 800/999-2782, ext. 3161.