November 4, 2016

Go Directly to Physical Therapy

Did you know that you can go directly to a physical therapist without a doctor’s referral? “Direct Access” rules for physical therapy vary by state.
  • Becky Wesolowski photo
    Becky Wesolowski

    Becky is a former employee of Restorations PT and graduated from Carnegie Mellon University.

Female physical therapist talking with a male patient on gym equipment

Did you know that you can go directly to a physical therapist without a doctor’s referral? “Direct Access” is mandated at the state level, and here in Pennsylvania you are allowed to be evaluated and treated by a PT for up to 30 calendar days. This means that if you have an injury, pain, weakness, vertigo, or any of a number of other issues for which a PT is qualified to treat, it may behoove you to first seek the help of a PT who has a Direct Access License.

What qualifies a physical therapist to make a diagnosis?

Physical therapists receive advanced education that includes clinical rotations followed by a licensure exam. Formerly, physical therapists earned a masters degree, but currently all entry-level PTs will have earned a Doctorate of Physical Therapy (DPT). Some PTs go on after receiving their degree and license to complete a fellowship or residency. Some specialize in some aspect of physical therapy such as pelvic floor rehab or vestibular rehab. All must complete continuing education courses in order to maintain their license (and even more to maintain their Direct Access License in PA). In addition to all this education, a PT gains experience through treating patients in their practice, just as in any other profession. Physical therapists are experts in body movement—they can evaluate a person’s condition, treat it, and also recognize when a condition is outside of the scope of PT. At that point they will refer a patient to a doctor or other specialist.

Do I need my doctor’s approval?

The short answer is yes, but there’s some gray area to note. Consider your physical therapist a key member in your healthcare team. At our clinic, Restorations PT, we want your doctors to know what is going on with your overall health, and that obviously includes your diagnosis and physical therapy plan of care. This just makes sense for the quality of healthcare in general. That’s why we say “yes, we want your doctor’s approval” despite the fact that for 30 days, we can appropriately treat you without it. We will send your detailed evaluation and a description of the treatment and goals to your doctor for approval or feedback. In the case of the patient who doesn’t have a doctor, Direct Access is a great benefit because this patient can receive the treatment and expertise of a PT for 30 days without issue.

But there are also a few technicalities depending on the individual. Patients with Medicare are allowed to see a PT without a referral, but Medicare also requires that a patient is under a physician’s care (or other allowable provider). This means your doctor will need to approve your plan of care. As always, we'll send the evaluation to your doctor and will in most cases save you a doctor's visit. Another circumstance to consider for all patients, not just those with Medicare, is that you may need more than 30 days to get back to your normal level of functioning. In PA, that’s a case where your doctor will need to approve your plan of care.

What are the other benefits of Direct Access?

Direct Access saves patients time and money. Instead of waiting to get in with your doctor or a specialist who is likely to prescribe PT, you can just go to PT, saving time and a copay (or deductible). You might avoid the use of pain medication and all the costs and side effects that come with it. Finally, you may avoid medical imaging such as an MRI because your physical therapist will look at your symptoms to make a specific diagnosis. PT and Direct Access can keep healthcare costs down in general.

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