APTA’s recently published report, "State of Direct Access to Physical Therapist Services," offers comprehensive research and strategic insights to assist in advocating for the removal of unnecessary barriers that limit patient access to physical therapist services.

The report follows years of advocacy by APTA and its members to eliminate the outdated referral requirements in state physical therapy licensure laws. While all states, the District of Columbia, and the U.S. Virgin Islands allow for direct access to evaluation and treatment, challenges remain in terms of consumer awareness, payment, and provisions tied to treatment.

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, FAPTA, 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.

PTs, PTAs, students, and supporters of the profession can help improve physical therapist services by:

• Advancing state-level advocacy with data from the report related to patient safety, outcomes, and cost-effectiveness
• Influencing payer policies and contract negotiations with report data that can be used in meetings, testimony, and other communications with policymakers, payers, and employers
• Changing facility policies using the resources in this report to eliminate barriers to direct access in place at a hospital or practice
• Increasing consumer awareness of the fact that direct access to PT services is a safe, effective option

The value of direct access to PT services is being realized in new and innovative models, such as technology-driven approaches to health care delivery; direct-to-employer contracting and care models; emerging and direct-to-customer payment models; and the growing role of PTs in emergency departments, urgent care centers, and primary care settings.

“Direct access to physical therapist services is well established as safe, effective, and essential to high-quality care,” says APTA President Kyle Covington, PT, DPT, PhD. “This report reinforces that fact with further evidence and provides a road map for continued progress. APTA calls on payers, regulators, and policymakers to remove the outdated and unnecessary barriers that still limit patient access to physical therapist services.”

“This is more than a report — it’s a tool for action,” Covington says. “We want policymakers and payers to use it to open doors, challenge outdated policies, and ensure patients get the care they need — when and where they need it.”