Physical therapists and patients have partial direct access in California, while other states have full direct access. Partial direct access allows patients to see a physical therapist without a referral or prescription for 12 visits or 45 days, whichever comes first. On the 13th visit, or the 46th day after the patient first sees the physical therapist, the patient must have a prescription from a physician or other entity which is allowed to write prescriptions in order to continue with their physical therapy.
Also, under partial direct access, California physical therapists must conduct an initial evaluation and recognize if there are factors or conditions that are beyond the scope of physical therapy that warrant a referral to other healthcare services. An example of this could be recognizing that an outpatient musculoskeletal patient that comes in for a physical therapy visit has an undiagnosed deep vein thrombosis (DVT); the patient should be referred to a physician prior to continuing physical therapy.
It is important to note that partial direct access for California only addresses the legal aspect of visits; it has nothing to do with insurance reimbursement. There are still insurances that require a physician’s prescription before they will pay for physical therapy. Like with many various forms of healthcare, insurance has become a large governing body that dictates what can and can’t be done, even if the healthcare provider and patient are in agreement.
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