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Direct access to PT services is a reality across America, but not without challenges.

Every state, the District of Columbia, and the U.S. Virgin Islands has lifted all or some of the referral requirements or order provisions for physical therapist evaluation and treatment, meaning that PTs can provide evaluation and treatment services without the need for an order or referral from any other health care professional in accordance with state law.

But there are more gains to be made. Your advocacy support is needed as we continue to fight for more effective direct access provisions at the state and federal levels.  And while Medicare also allows direct access, providers must carefully follow rules and regulations.


Recommended Content

Tips for Adopting Direct Access in Your Practice

May 3, 2020 / Article

Direct Access and Medicare

May 4, 2020 / Article

Direct Access Advocacy

Apr 24, 2020

More needs to be done to improve direct access in states across the country.


Additional Direct Access in Practice Content

Researchers: Direct Access Works in the U.S. Civilian Health Care System

Dec 7, 2020 / Review

A new study affirms that direct access to physical therapy improves outcomes and lowers cost for patients with back pain.

Direct Access and Medicare in Hospital-Based Outpatient Settings

May 3, 2020 / Article

CMS has specific regulations that impact direct access services in hospital-based outpatient settings.

Improving Direct Access at the State Level

Feb 12, 2020 / Article

PTs have all the training and skills necessary to provide diagnosis and treatment without a physician’s referral and without arbitrary restrictions.

The Five Things I've Learned as a Cash-Based Physical Therapy Practice Owner

Feb 7, 2020 / Perspective

I started a cash-based practice because I really did not feel that I had any other options.

APTA Cosponsored Study: Direct Access to Physical Therapy for LBP Saves Mon...

Nov 8, 2019 / Review

Does unrestricted direct access to a physical therapist (PT) make a difference compared with "provisional" direct access systems?

Ordering of Diagnostic Imaging by PTs: A Practice Analysis - PTJ

Aug 9, 2019 / Podcast

As more PTs transition into direct access roles, it seems prudent to consider how additional resources common to other first-contact providers might impact patient care.

NEXT 2018: Dreaming Big to Improve Health Care

Aug 15, 2018 / Podcast

Julie Sexton, PT, and Michelle Ramirez, PT, DPT, discuss their health system’s process for translating evidence into practice and expanding care through direct access.

Study: Seeing a PT First for LBP Lowers Overall Costs, Reduces Chances of L...

May 24, 2018 / Review

A new study finds additional benefits to receiving physical therapy for LBP as a first-line approach.

CSM 2018: Low Back Pain Research

Mar 19, 2018 / Podcast

Kenneth Harwood, PT, PhD, discusses research that studies whether unrestricted direct access to physical therapist services lowers utilization and health care costs for people with low back pain.

Study: Direct Access is Safe, Effective, and Cheaper Than Referral-Based Care

Nov 10, 2017 / Review

Patients via direct access had significantly lower medical costs—an average of $1,543 less per patient.