The Laws are Changing!

You may have heard that there was “some law” that was passed and that “something about physical therapy” is changing in Texas. If you have not heard about this, do not worry, that is what this post is about!


During the most recent Texas legislative session, HB 29 was passed. This is also known as “The Direct Access to Physical Therapy in Texas” bill. This bill will take effect September 1, 2019. Here is what the law says: “A Doctor of Physical Therapy can treat without a referral for 10 consecutive days” (or 15 consecutive days, depending on the training of the therapist), if the following conditions are met:

  • 1. The therapist has at least 1 year of clinical experience AND the patient signs a disclosure that states:
  • * The treatment provided is not based on a medical diagnosis (from a physician)
  • *The treatment provided is not based on radiographic imaging (i.e. x-rays, MRI’s, etc.)
  • * The treatment provided may or may not be covered by the patient’s health plan

  • 2. A therapist with a master’s or Bachelor’s degree can treat without a referral for 10 consecutive days if:
  • *The therapist has at least 1 year of clinical experience
  • *The therapist completes 30 hours of continuing education in differential diagnosis (training to recognize other conditions that may not be appropriate to treat with physical therapy and may need a referral back to a physician)
  • *The patient signs the disclosure stating the points above.

  • 3. Any physical therapist treating without a referral must be covered by professional liability insurance.


What this means is that the new law has increased the ease of patients to be treated by a physical therapist. Prior to this law, in Texas, a physical therapist could evaluate a patient without a referral from a qualified referral source, but could not provide treatment without that referral.

The way the law is written now, a physical therapist can evaluate and treat the patient without a referral from the physician, if the specific criteria are met.


For the patient, this allows you to begin to get the treatment needed sooner. One of the biggest complaints physical therapists hear is, “why didn’t we start therapy sooner?” Often it is because the system that was in place required certain steps before you were treated by a physical therapist.


  1. 1. Is this safe for the patient?
  2. *The profession of physical therapy has been working towards this for years. It is a big reason the profession started requiring PT schools to offer the Doctorate of Physical Therapy (DPT) degree. Also, Texas is the last state in the country to enact any version of Direct Access. This means many other states have had similar laws, for years in some cases, and to our knowledge, no major safety concerns have emerged. Physical therapists are well trained to recognize when a patient presents with signs and symptoms that are “not normal” for what a PT is able to treat.

  1. 2. What about the doctors?
  2. *At FWPT, we do not see this law as something that should divide the physician and therapist relationship. As therapists, we are not claiming that we can diagnose or that we “don’t need the doctors.” We (physical therapists) are a PART of the medical team. This law will hopefully allow us to work even closer with our physician colleagues. You may start your care before you see the physician, but our encouragement to you (the patient) is to follow up with your physician if you have any concerns what so ever. AND, if you do not have a primary care physician, or you don’t know a great orthopedic surgeon, let us help you find a good fit!

  1. 3. Will my insurance pay for physical therapy if I do not have a referral from a physician?
  2. *At this time, we do not know the answers to that question. HOWEVER, you always have the option to see our therapists at our cash rates! We offer a very competitive rate to be treated by our therapists, sometimes it costs less than if you are paying towards a high deductible!

  1. 4. Which types of patients will benefit most from this change?
  2. a. Patients with an acute injuries that need help fast.
  3. b. Patients with reoccurring episodes of a chronic issue (preferably whose condition has been evaluated by a physician at some point, and determined to be benign)
  4. c. Patients that plan to see their doctors, but are having to wait a week or two to see them. (A jump start in PT may help your doctor to make a more informed decision on your care knowing how therapy helped or did not help. This could cut down on the time to truly receive the care you need, whether it is therapy, pharmaceuticals, injections, surgery, a referral to a specialist,etc.)
  5. d. Persons whom may not be in pain, but are looking to enhance their performance is specific activities, sports, recreational activities, or whom just want to function at the highest level that they can!

  1. 5. Which types of patients will not benefit most from this change?
  2. a. Patients that have signs of a medical emergency. (This is not in the scope of a PT to offer care during an emergency, unless there is not other option. Please call 9-1-1 or go to the emergency room for an emergency.)
  3. b.Patients that recently had surgery. (Starting therapy will depend on your surgeon.)

  1. 6. What should I do if I want to take advantage of the improved access to physical therapy for my health and wellness?
  2. Call us today! We can help you navigate the in’s and out’s of the changes!