Do you need a referral for physical therapy?

Want to see a physical therapist but don’t have a referral from a physician? You might think that you’ll have to make an appointment with your doctor to get one. But, not so fast. Thanks to something called direct access, you may not need a referral from your doctor before going to physical therapy. 

What is direct access?

At the basic level, direct access refers to laws that allow people to use health care services, including physical therapy, without a doctor’s referral. This can be very beneficial for patients. In fact, one study showed that patients with direct access to physical therapy required fewer physician visits and had less of a need for anti-inflammatory drugs. They also had lower overall medical costs. However, there are different levels of direct access that can affect your ability to get the care you need. 

What are the different types of direct access?

It’s important to know the direct access laws that your state has on the books because every state has its own laws of direct access. In addition, not every state has the same type of laws about direct access to physical therapy.

Three different types of direct access laws exist across the country. Each type indicates the restriction level you will face when accessing physical therapy. The three types of direct access laws are:

• Unrestricted direct access — In a state with unrestricted direct access, you don’t need to go to a health care provider first. Also, there are no other legal restrictions or limitations on the physical therapy you can receive.
• Provisional direct access — Provisional direct access laws allow patients to see physical therapists with some provisions that vary by state. Some of the restrictions laid down by provisional direct access laws include time and/or visit limits and physician referrals for specific PT interventions.
• Limited direct access — In limited direct access states, patients must have had a prior relevant medical diagnosis, a recent diagnosis from a physician or other specified clinician, and/or a prior physician referral to a physical therapist before they can seek PT without a referral. These restrictions vary somewhat by state. 

Direct access provisions to keep in mind

There are 27 states that have provisional direct access laws, which makes provisional direct access the most common law type. As a result, many people who would like to go to physical therapy without a referral may need to know the common types of provisions these laws include.

Here are some of the common provisions you may need to know about before calling your local physical therapist:
 

1. Physical therapists cannot make a medical diagnosis.
   
   In many provisional direct access states, only a licensed medical doctor can make a medical diagnosis. If the physical therapist feels that a medical diagnosis is necessary before physical therapy treatment, they must refer the patient to a medical doctor.
    
2. Physical therapists must refer the patient to a specialized clinic or licensed health care provider if the patient’s condition is beyond the PT’s scope of practice.
   
   A patient’s condition may need intensive care beyond the physical therapy clinic. If this is the case, then a physical therapist must send the patient to a different clinic or practice so that they can be properly treated.
    
3. If a patient will need more than 120 days of PT treatment, physical therapists must consult with a licensed health care provider.
   
   Provisional direct access laws may also require physical therapists to refer patients to another health care provider if they have not improved within a specific time frame. Maine’s provisions provide a perfect example of this. Maine’s provisional direct access law requires physical therapists to refer patients to an appropriate licensed health care provider if:

• The patient’s condition requires more than four months of treatment. 
• The patient’s condition has shown no measurable improvement within 30 days of their first treatment date.

Alliance PTP is ready to help you find direct access to top-notch physical therapy

At Alliance Physical Therapy Partners, we’re proudly bringing together physical therapy practices across the country to help people get the high-quality PT they need. And all of our providers are in states with some form of direct access to physical therapy.* 

Want to see a physical therapist in person? We can put you in touch with an Alliance PTP partner that’s close to you and that can help you address a range of injuries and chronic conditions. 

Not keen on in-person PT sessions or not close to an Alliance PTP partner? No worries. We also offer effective and affordable virtual physical therapy through our Agile Virtual Physical Therapy platform. 

Contact our team today so we can help you find the most effective physical therapy services for your injury or condition.

*NOTE: Each Alliance Physical Therapy Partners’ provider is subject to varying types of direct access laws. Patients should review the direct access laws their chosen provider is subject to prior to making an appointment.