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Patients in all 50 states, the District of Columbia, and the U.S. Virgin Islands have either provisional or unrestricted direct access to physical therapist services for evaluation and treatment.  Even though patients may go directly to a physical therapist without a referral, some provisions tied to treatment absent a referral still persist in a number of states — despite evidence that unrestricted direct access benefits patients, providers, employers, payers, and the U.S. health care system.

APTA’s “State of Direct Access to Physical Therapist Services” report is a strategic resource designed to equip health care leaders with the scientific evidence they need to address opposition to direct access and drive meaningful change. 

The report includes a concise history and status of direct access across the U.S.; strategic insights for use in payer, employer, and policy negotiations; and summarized evidence compiled by William Boissonnault, PT, DPT, DHSc, and Karen Lovely, PT, DPT, addressing common concerns raised by insurers, regulators, and other stakeholders. That evidence is arranged by topics including patient safety, functional outcomes, physical approval, and patient satisfaction, among others.

Use this resource to address barriers that limit access to PT services in the following ways:

  • Advance state-level advocacy
  • Influence payer policies and contract negotiations
  • Change facility policies
  • Increase consumer awareness

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