How Direct Access to Physical Therapy Works

Table of ContentsView AllTable of ContentsWhat Is Direct Access?Benefits of Direct AccessIs Direct Access Safe?Who Can Self-Refer?Direct Access Policies

Table of ContentsView All

View All

Table of Contents

What Is Direct Access?

Benefits of Direct Access

Is Direct Access Safe?

Who Can Self-Refer?

Direct Access Policies

This article will discuss what direct access is and how it is used for physical therapy services. It will also discuss how direct access differs depending on your health insurance plan and the state where you live.

Sometimes you may have back or knee pain because of an obvious injury like a sprain or a pulled muscle. Direct access gives you the power to decide if you needphysical therapy. Sometimes direct access is called self-referral.

In the United States, each state controls physical therapy services through a “state-practice” act.The practice act is a law that says how physical therapy services can be delivered in that state. Each state lists different professionals who may refer patients to physical therapy, includingpodiatrists,dentists, and nurse practitioners.

Science Photo Library / Getty Images

Physical therapist works on woman’s lower leg

Benefits of Direct Access Physical Therapy

Many conditions can be successfully evaluated and treated with no expensive medical tests. Visiting your physical therapist directly allows you to start on treatment right away with very little risk of further injury. Physical therapy is a low-cost, value-packed healthcare service.

Some people who don’t agree with the idea of direct access to physical therapy services argue that patients may be put at risk if they visit a physical therapist on their own. Physical therapists lack the ability to order certaindiagnostic testsor prescribe medication to help manage pain.

To date, there is no research showing that self-referral to physical therapy puts patients at increased risk. Also, there is no evidence that self-referred patients spend more on healthcare during or after their physical therapy care visits.

Physical therapists are also trained to spot “red flags” that may point to the need for more extensive medical treatment, such as surgery. In those cases, the physical therapist immediately refers you to your physician or healthcare provider.

There is no evidence that self-referral to physical therapy puts patients at increased risk. Self-referred patients also don’t spend more healthcare dollars during or after physical therapy visits.

Many states also have safety nets built into their practice acts. For instance, some states allow direct access only to therapists who have been practicing for three or more years.

Others allow a certain time frame or a specific number of physical therapy visits during an episode of care. If the patient requires skilled physical therapy after the time frame or number of visits is reached, the patient has to see a healthcare provider to continue treatment.

If you have a musculoskeletal condition that interferes with your ability to move without pain, use your best judgment when deciding which healthcare provider to see. A visit to your local physical therapist is a safe place to start on the road to recovery.

Who Can Self-Refer to PT?

How do you know if you can self-refer to physical therapy and get your health insurance to help pay for it? First, take a look at your health insurance policy. Here are some things you should check for:

States With Direct Access Policies

Most states have policies about direct access and self-referral. In fact, direct access is available in some form in all 50 states, plus the District of Columbia. The rules differ depending on what state you live in.

You can check theAPTA direct access mapto see what rules, if any, your state has for direct access. If you are unsure if physical therapy is right for you, a discussion with your healthcare provider may be necessary to help you decide.

Summary

Direct access allows you to visit a physical therapist without waiting for a healthcare provider’s referral. The level of access you have depends on your health insurance plan and the state where you live. Direct access may provide you with the opportunity to save both time and money since you don’t have to see a healthcare provider first.

4 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.APTA.Scope of practice.Rao B, Hellander I.The widening U.S. health care crisis three years after the passage of ‘Obamacare.’Int J Health Serv. 44(2):215-232. doi:10.2190/HS.44.2.bOjha HA, Snyder RS, Davenport TE.Direct access compared with referred physical therapy episodes of care: a systematic review.Physical Therapy. 94(1):14-30. doi:10.2522/ptj.20130096NYS Physical Therapy.Office of the Professions: Frequently Asked Practice Questions.Additional ReadingPendergast J, Kliethermes SA, Freburger JK, Duffy PA.A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy.Health Serv Res. 47(2):633-654. doi:10.1111/j.1475-6773.2011.01324.x.APTA.Direct Access in Practice.

4 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.APTA.Scope of practice.Rao B, Hellander I.The widening U.S. health care crisis three years after the passage of ‘Obamacare.’Int J Health Serv. 44(2):215-232. doi:10.2190/HS.44.2.bOjha HA, Snyder RS, Davenport TE.Direct access compared with referred physical therapy episodes of care: a systematic review.Physical Therapy. 94(1):14-30. doi:10.2522/ptj.20130096NYS Physical Therapy.Office of the Professions: Frequently Asked Practice Questions.Additional ReadingPendergast J, Kliethermes SA, Freburger JK, Duffy PA.A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy.Health Serv Res. 47(2):633-654. doi:10.1111/j.1475-6773.2011.01324.x.APTA.Direct Access in Practice.

APTA.Scope of practice.Rao B, Hellander I.The widening U.S. health care crisis three years after the passage of ‘Obamacare.’Int J Health Serv. 44(2):215-232. doi:10.2190/HS.44.2.bOjha HA, Snyder RS, Davenport TE.Direct access compared with referred physical therapy episodes of care: a systematic review.Physical Therapy. 94(1):14-30. doi:10.2522/ptj.20130096NYS Physical Therapy.Office of the Professions: Frequently Asked Practice Questions.

APTA.Scope of practice.

Rao B, Hellander I.The widening U.S. health care crisis three years after the passage of ‘Obamacare.’Int J Health Serv. 44(2):215-232. doi:10.2190/HS.44.2.b

Ojha HA, Snyder RS, Davenport TE.Direct access compared with referred physical therapy episodes of care: a systematic review.Physical Therapy. 94(1):14-30. doi:10.2522/ptj.20130096

NYS Physical Therapy.Office of the Professions: Frequently Asked Practice Questions.

Pendergast J, Kliethermes SA, Freburger JK, Duffy PA.A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy.Health Serv Res. 47(2):633-654. doi:10.1111/j.1475-6773.2011.01324.x.APTA.Direct Access in Practice.

Meet Our Medical Expert Board

Share Feedback

Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit

Was this page helpful?

Thanks for your feedback!

What is your feedback?OtherHelpfulReport an ErrorSubmit

What is your feedback?

Benefits of Direct Access Physical Therapy#

Who Can Self-Refer to PT?#

States With Direct Access Policies#

Summary#

Benefits of Direct Access Physical Therapy

Who Can Self-Refer to PT?

States With Direct Access Policies

Summary