Do you need a referral to see a physical therapist in Texas?

Beginning September 1, 2019, Texans who want treatment for an injury or pain management can see a physical therapist without first visiting a physician for a referral. Texas Governor Greg Abbott signed Direct Access Bill 29 to make Texas the 49th state to allow physical therapists to treat you without a doctor’s order.

Previously Texas physical therapists were able to evaluate but not treat patients. HB29 removes that barrier, allowing patients to bypass wait times for referrals from physicians to PTs and unnecessary expenses, but with provisions:

• Treatment without a referral for up to ten (10) consecutive business days for a physical therapist with a doctoral degree in physical therapy or who has completed a minimum of thirty (30) continuing competence activities in the area of differential diagnosis.
• Additionally, a PT with a doctoral degree in physical therapy who has completed a residency or fellowship can treat for up to fifteen (15) consecutive business days without a referral.
• Stipulations on treatment without a referral are the PT must have been licensed to practice physical therapy for at least one (1) year and must be covered by professional liability insurance.
• Before treatment can exceed the authorized number of days, a referral must be obtained from a qualified healthcare practitioner.

A major study came to the conclusion that evaluation, management and treatment without referral allows patients to be examined and receive safe, effective treatment earlier. The findings suggest that PTs have training and expertise to screen patients for appropriate PT care and to recognize the need for additional medical intervention.1 DOC physical therapists have the healthcare luxury of immediate access to the expansive DOC healthcare team of orthopedic surgeons, pain management physicians, specialty-trained PAs, and RTs.

Most insurance companies reimburse for physical therapy services without a physician referral. Check with your insurance provider about your coverage or ask your DOC healthcare provider to help to verify benefits. Medicare doesn’t pay for physical therapy without a referral, but there are efforts to change those laws at the federal level.

With HB 29 in effect, DOC Texas Physical Therapy is an effective first healthcare option for DOC guests suffering from an injury, chronic condition or pain.

For more information on the cost of care, click here

(KTRE) - A new law taking effect Sept. 1 will allow Texans who want treatment for an injury or pain management to see a physical therapist without first visiting a physician or other healthcare provider.

Texas Governor Greg Abbott signed House Bill 29, which will allow Texans to seek treatment from a physical therapist without first receiving a referral from a physician.

“Texas Hospital Association, Texas Medical Association, and Texas Orthopedic Association all spoke against it, but did come to the compromise we have now,” said Laurie Hurst, a physical therapist with her doctoral of physical therapy. “We have a limited period of time where can see a patient without a referral. That is to prevent things from going on too long if they really do need a medical referral to their doctor.”

Physical therapists must first earn their doctorates in Physical Therapy in order to see patients without a referral, or must earn Continuing Education Credits (CEU).

Currently, a limited number of private insurance companies pay for physical therapy without a referral. Still, with high deductibles people may see a cost savings going directly to the physical therapist, rather than spend time and money at a physician’s office.

“The charge still applies toward your deductible,” said Hurst.

Additionally, Medicare doesn’t pay for physical therapy without a referral, yet. Hurst says there are efforts to change those laws at the federal level.

“It certainly would make the whole network of getting medical care a lot easier," said Carol Shaw, a patient at NRG Aquatic Physical Therapy. “I do appreciate the increased requirement in terms of training to protect the profession from those who would pretend what they are not. I appreciate it very much.”

As for patients who may skip a physician for financial reasons, a window of care -- 10 business days or more, according to Texas Physical Therapy Association -- is in place to ensure patients are receiving proper treatment from which they are benefiting.

“If the individual or condition is above the skills of the physical therapist, of course, we do refer them back to doctors for more medical examination. In which it boils down to the Hippocratic Oath of healthcare providers, which is first, do no harm," said Jeffrey Cuevas, a physical therapist at NRG.

On Sept. 1, Texas becomes the 49th state to allow patients direct access to physical therapy. Other states have repeatedly shown the benefits in terms of both positive patient outcomes and financial swing, states trade publications.

Copyright 2019 KTRE. All rights reserved.

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