Yesterday, I broke down the what’s what of direct access laws by state, starting in Alabama and ending in Hawaii. Today, I’m continuing our guided tour of direct access law by kicking things off in Idaho and making our way down the list to Mississippi. (Don’t worry about gas money: we’ll do it all from the comfort of our homes or offices.) Just to reiterate, I’m not a legal or compliance expert, and all of the following information has been adapted from this APTA document. So, if you’re ready to up your practice's direct access game, be sure to consult an attorney or PT compliance guru who is familiar with your state’s physical therapy practice act beforehand. With that said, let’s get to it:

Triumph in the Triple-Aim Game: The Healthcare Executive’s Guide to Readmission Reduction, Patient Safety Promotion, and ACO Success - Regular BannerTriumph in the Triple-Aim Game: The Healthcare Executive’s Guide to Readmission Reduction, Patient Safety Promotion, and ACO Success - Small Banner

Idaho

  • Idaho is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.
  • While direct access to a physical therapist is not restricted in Idaho, a PT must refer a patient to the appropriate healthcare provider if the therapist feels the patient’s condition is beyond the physical therapy scope of practice.
  • PTs are prohibited from radiological, surgical, or medical diagnosis of disease.  

Illinois

  • Illinois is one of six states that allow limited direct patient access to a physical therapist.
  • Physical therapists may only evaluate patients and/or provide fitness and wellness services and limited treatment if the following criteria are met:
    • The patient can obtain a documented referral or relevant diagnosis from the appropriate healthcare provider.
      • The PT must notify the appropriate healthcare provider that the patient is receiving treatment pursuant to that diagnosis.
    • If the PT determines that the patient’s condition is beyond the physical therapy scope of practice, the PT must refer the patient to the appropriate healthcare provider.

Indiana

  • Indiana is one of 26 states that allow direct patient access to PT with some provisions.
  • To practice via direct access, a PT must:
    • Evaluate and treat the patient for no more than 24 calendar days, starting on the initial date of service, without a referral.
      • If the patient requires additional treatment, the physical therapist must obtain a referral from the appropriate healthcare provider.  
    • Obtain an order or referral from a physician, osteopath, or chiropractor when PT treatment involves spinal manipulation. The referring provider must have conducted his or her own examination of the patient before issuing the order or referral.
      • The APTA defines “spinal manipulation” as “a method of skillful and beneficial treatment by which a physical therapist uses direct thrust to move a joint of the patient’s spine beyond its normal range of motion, but without exceeding the limits of anatomical integrity.”
    • Obtain an order or referral from a physician, osteopath, or podiatrist in the case of sharp debridement.
      • The APTA defines “sharp debridement” as “the removal of foreign material or dead tissue from or around a wound, without anesthesia and with generally no bleeding, through the use of: (A) a sterile scalpel; (B) scissors; (C) forceps; (D) tweezers; or (E) other sharp medical instruments...to expose health tissue, prevent infection, and promote healing.”

Iowa

  • Iowa is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.
  • PTs may evaluate and treat direct access patients without a referral. However, some hospitals may require that any PT evaluations and treatments performed in the hospital only be provided upon prior authorization from a member of the hospital’s medical staff.  
  • Physical therapists may not:
    • perform operative surgery;
    • conduct osteopathic or chiropractic manipulation; or
    • prescribe drugs and medicine.

Download the PT's Guide to Direct Access Law in All 50 States.

Enter your email address below, and we’ll send you a comprehensive guide to direct access laws in your area.

Please enable JavaScript to submit form.

Kansas

  • Kansas is one of 26 states that allow direct patient access to PT with some provisions.
  • In Kansas, a PT may evaluate and initiate treatment on a patient without a referral. If a direct access patient does not progress toward documented treatment goals within 10 visits or 15 business days (whichever comes first) from the first date of treatment following the initial evaluative visit, the PT must obtain a referral from an appropriate licensed healthcare practitioner.
  • Before treatment can begin, the physical therapist must provide written notice to any self-referring patient that a physical therapy diagnosis and a medical diagnosis are not one in the same.  
  • The PT must obtain approval from an appropriate, licensed healthcare provider before performing wound debridement.  
  • If the patient is currently being treated in a hospital or ambulatory surgery center, the facility may require a physician order or referral for PT services.  
  • Physical therapists may provide—without a referral—services that do not treat a specific condition in the following scenarios:
    1. workplace injury prevention; or
    2. public education related to fitness, disease prevention, and health promotion.  
  • PTs can also provide services to special education students without a referral if the treatment or services will allow the students to meet the provisions of their individualized education plans (IEPs) or individualized family service plans (IFSPs).

Kentucky

  • Kentucky is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.
  • While Kentucky allows unrestricted direct access to PT services, a physical therapist must refer a patient to an appropriate licensed healthcare provider when the patient’s condition exceeds the physical therapy scope of practice.  
  • Additionally, when a patient is referred to a physical therapist for treatment, the PT shall confer with the referring provider.

Louisiana

  • Louisiana is one of 26 states that allow direct patient access to PT with some provisions.
  • To practice via direct access, a PT must:
    • Obtain a doctorate-level degree or have five years of clinical practice experience.
      • These providers may only treat a patient without physician referral for 30 calendar days.  
      • After 30 days, the PT must obtain a referral from an appropriate healthcare provider, unless there is measurable or functional improvement.

Maine

  • Maine is one of 26 states that allow direct patient access to PT with some provisions.
  • To practice via direct access, the physical therapist:
    • Must not apply manipulative thrust to the vertebrae of the spine.
    • Must not administer drugs.
    • Must make a referral when the patient’s condition requires treatment beyond the PT’s scope of practice.
  • When treating a patient without referral, the PT:
    • Cannot make a medical diagnosis;
    • Must refer the patient to an appropriate licensed healthcare provider if no improvement is noted in the patient record within 30 days of the first treatment date;
    • Must consult or refer the patient to an appropriate licensed healthcare provider if PT treatment is required beyond 120 days.  
  • Employers may not cover workers’ compensation charges for PT services unless the employee has been specifically referred to the PT.

Maryland

  • Maryland is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.

Massachusetts

  • Massachusetts is one of 18 states that allow patients total, unrestricted access to a physical therapist. No type of physician referral is required for a physical therapist to treat a patient.
  • If the PT feels that the patient’s care goes beyond the physical therapy scope of practice, or if PT is contraindicated, the therapist must refer the patient to an appropriate licensed practitioner.
  • If the patient was referred to the PT, the PT must communicate with the licensed referring practitioner throughout duration of treatment.
    • The PT must also disclose to the patient any financial interest if the referring physician derives income from the PT services.

Michigan

  • Michigan is one of 26 states that allow direct patient access to PT with some provisions.
  • A PT may treat direct access patients when:
    • The treatment lasts for 21 days or 10 individual treatments—whichever occurs first.
      • The PT must confirm that the patient requires physical therapy before allowing a physical therapist assistant to perform treatment interventions.
    • A patient receives services for injury prevention, wellness, or fitness.  
    • The patient is referred to an appropriate healthcare professional if the PT feels that the patient’s care goes beyond his or her scope of practice.
    • An appropriate healthcare provider is consulted if the patient does not respond to treatment in an appropriate length of time based on the standards of practice determined by the Board of Physical Therapy.

Minnesota

  • Minnesota is one of 26 states that allow direct patient access to PT with some provisions.
  • A PT treating direct access patients is contingent upon the following:
    • A PT may not determine medical diagnosis.
    • A patient may be seen by a PT without referral for up to 90 days.  
    • A physical therapist who has been licensed for less than one year may only provide PT services when working alongside a physical therapist who has more than one year of practicing experience.
    • The PT must refer the patient to an appropriate healthcare professional if the PT feels that the patient’s care goes beyond his or her scope of practice.
  • A PT may treat a direct access patient without a time limitation if the patient is seeing the PT for disease prevention, wellness, fitness education, or exercise services.

Mississippi

  • Mississippi is one of six states that allow limited direct patient access to a physical therapist.
  • A physical therapist may only provide services on a direct access basis:  
    • To any child diagnosed with a developmental disability if physical therapy is pursuant to the patient's plan of care.  
    • If the PT is acting as part of a home health agency or long-term care facility and therapy aligns with the patient's determined plan of care.
    • If the patient is seeing the PT for injury prevention, wellness, stress reduction, or fitness services.
    • If the patient has previously received a diagnosis for any condition(s) within the last 180 days that necessitate PT services—and the therapist has notified the provider who determined the diagnosis.
      • Within the first 15 days of therapy, the PT must provide a plan of care to the provider who determined the diagnosis.

Well folks, we’ve made it to the halfway point. I’ll be back at it on Monday covering the finer details of direct access law from Missouri to Pennsylvania. Itching to learn more about direct access across the nation? Be sure to check out The PT’s Guide to Direct Access Law in All 50 States. Hasta luego!

  • Direct Access Laws by State (Alabama-Hawaii) Image

    articleDec 8, 2017 | 10 min. read

    Direct Access Laws by State (Alabama-Hawaii)

    If you’re a physical therapist—and you’re licensed in the United States—then you’re practicing in a direct access state. That’s right: In all 50 states—as well as the US Virgin Islands and DC—direct access to at least a physical therapy evaluation is the law of the land. But, before you start seeing every patient who walks through your door without a physician referral, there are a few things you ought to know. The laws around direct access can …

  • Direct Access Laws by State (Missouri-Pennsylvania) Image

    articleDec 12, 2017 | 9 min. read

    Direct Access Laws by State (Missouri-Pennsylvania)

    If you haven’t been keeping up with the WebPT Blog over the past few days, here’s what you’ve missed: I’ve been breaking down all of the state-level direct access laws from coast to coast. (You can check out the laws for Alabama to Hawaii here and Idaho to Mississippi here .) If you have been keeping up, then welcome back! (Cue the “Welcome Back, Kotter” theme song.) Today, I’m tackling the laws from M to P—that’s Missouri …

  • Direct Access Laws by State (Rhode Island-Wyoming) Image

    articleDec 13, 2017 | 10 min. read

    Direct Access Laws by State (Rhode Island-Wyoming)

    Well folks, it’s been a heck of a journey, but we’ve finally made it to the last leg. In the final installment of this four-part series, we’ll be hitting up New England and making our way cross-country to the Cowboy State. (Previously, I covered Alabama - Hawaii , Idaho - Mississippi , and Missouri - Pennsylvania .) But before we get down to business, I’d be remiss if I didn’t mention that I’m by no means a …

  • Common Questions from Our New PT and OT Evaluation Codes Webinar Image

    articleDec 19, 2016 | 20 min. read

    Common Questions from Our New PT and OT Evaluation Codes Webinar

    This month’s webinar on the new CPT codes was our biggest one yet—more than 11,000 people registered to attend. With such a large—and clinically diverse—audience, we received a ton of questions. And due to time constraints, our hosts—WebPT’s own Heidi Jannenga and compliance expert Rick Gawenda—weren’t able to get to even a fraction of them during the live broadcast. Not to worry, though; we’ve done our best to answer them all here, in one giant FAQ article. …

  • Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs Image

    articleNov 9, 2016 | 8 min. read

    Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs

    Halloween may be over, but if you didn’t get your fill of scares, I’ve got the perfect activity for you: reading through 1,401 pages of pure Medicare gobbledygook. Screaming yet? (Or should I check back at around page 500?) I kid, of course; there’s no need for you to slog through this year’s extra meaty Final Rule —which details the Medicare fee schedule and other important Medicare regulatory and reimbursement changes for physical therapy, occupational therapy, and …

  • Get Over Opioids: Join the #ChoosePT Movement Image

    articleJun 27, 2016 | 4 min. read

    Get Over Opioids: Join the #ChoosePT Movement

    Patients are supposed to trust their doctors. So, when your doctor writes you a prescription, you usually don’t question it; you fill it, take it, and hope that it will make you better. But, what happens when a prescription turns into an addiction? Unfortunately, millions of Americans have learned the answer to that question the hard way. The Painkiller Problem As the APTA explains in a recent position paper titled, “Opioid Abuse and the Role of Physical …

  • New Year, New Codes: How to Bill for PT and OT Evaluations in 2017 Image

    webinarOct 27, 2016

    New Year, New Codes: How to Bill for PT and OT Evaluations in 2017

    As we prepare to ring in the new year, PTs and OTs also must prepare to ring in a new set of CPT codes for therapy evaluations and re-evaluations. That’s right—the ball isn’t the only thing dropping on January 1, 2017. On that day, all of the existing PT and OT evaluative codes—including 97001, 97002, 97003, and 97004—are fading into the annals of history. In their place will be eight new codes: three for PT evals, three …

  • Common Questions from our Cloudy with a Chance of Reform Webinar Image

    articleFeb 13, 2017 | 13 min. read

    Common Questions from our Cloudy with a Chance of Reform Webinar

    In our first webinar of 2017 , WebPT’s co-founder and president, Heidi Jannenga, teamed up with CEO Nancy Ham to discuss the current and future healthcare trends that will impact PTs, OTs, and SLPs. (Missed it? No worries; you can view the complete recording here .) As always, we received quite a few questions during the presentation—way more than we could address live. So, we’ve put them all here, in one handy Q&A doc. Scroll through and …

  • Top Regulatory Changes of 2014 Image

    articleDec 22, 2014 | 3 min. read

    Top Regulatory Changes of 2014

    Ch-ch-ch-changes : We’ve seen a plethora of regulatory changes this year in the PT space—from the ICD-10 delay to the therapy cap increase. Although some of these legislative twists and turns have caused headaches for therapists, others have been hugely positive. For instance, some form of direct access is now available in all 50 states as well as Washington, DC, and the US Virgin Islands. Read on to learn this year’s top regulatory changes. Regulatory Heavy-Hitters of …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.