I 
111TH CONGRESS 
1ST SESSION H. R. 1829 
To amend title XVIII of the Social Security Act to authorize physical thera-
pists to evaluate and treat Medicare beneficiaries without a requirement 
for a physician referral, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 31, 2009 
Mr. POMEROY (for himself, Mr. TIM MURPHY of Pennsylvania, Ms. BALDWIN, 
Ms. DELAURO, Mr. RUPPERSBERGER, Mr. ROSS, Mr. OLVER, Mr. TURN-
ER, Mr. FARR, Mr. KIRK, Mr. PITTS, Mr. GERLACH, Mr. HIGGINS, Mr. 
CHANDLER, Mr. MORAN of Kansas, Mr. ROGERS of Kentucky, Mr. INS-
LEE, Mr. GRAVES, Mr. SHUSTER, Mr. CONAWAY, Mr. MICHAUD, Mr. 
PAUL, Mr. LANGEVIN, Mr. HINCHEY, Mr. BISHOP of Utah, Mr. PLATTS, 
Mrs. EMERSON, Mr. BLUMENAUER, Mr. MEEK of Florida, Mr. SESTAK, 
Mr. NEAL of Massachusetts, Mr. SHIMKUS, Mr. WILSON of South Caro-
lina, Mr. PUTNAM, Mr. MCGOVERN, Mr. BUTTERFIELD, Mr. LINCOLN 
DIAZ-BALART of Florida, Mr. DEFAZIO, Mr. ISRAEL, Mr. BISHOP of 
Georgia, Mr. TIERNEY, Mr. ROHRABACHER, Mrs. CAPPS, Mr. LOEBSACK, 
Mr. GRIJALVA, Mr. ROGERS of Alabama, Mr. ELLISON, Mr. OBERSTAR, 
Mr. WU, Mr. FRANKS of Arizona, Mrs. MALONEY, Mr. JONES, Mr. GARY 
G. MILLER of California, Mr. YOUNG of Alaska, Mr. GENE GREEN of 
Texas, Mr. KILDEE, and Mr. ALTMIRE) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to authorize 
physical therapists to evaluate and treat Medicare bene-
ficiaries without a requirement for a physician referral, 
and for other purposes. 
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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicare Patient Ac-
cess to Physical Therapists Act of 2009’’. 
SEC. 2. ACCESS TO OUTPATIENT PHYSICAL THERAPY SERV-
ICES FOR MEDICARE BENEFICIARIES AS AU-
THORIZED BY STATE LAW. 
(a) IN GENERAL.— 
(1) ELIMINATION OF REQUIRED PHYSICIAN RE-
FERRAL.— 
(A) DEFINITION
OF
OUTPATIENT
PHYS-
ICAL THERAPY SERVICES.—Section 1861(p) of 
the Social Security Act (42 U.S.C. 1395x(p)) is 
amended— 
(i) in the matter preceding paragraph 
(1), by striking ‘‘as an outpatient’’; 
(ii) by amending paragraph (1) to 
read as follows: 
‘‘(1) who is an outpatient, and’’; 
(iii) in paragraph (2)— 
(I) by striking ‘‘physician (as so 
defined) or by a qualified physical 
therapist’’ and inserting ‘‘physician 
(as defined in paragraph (1), (3), or 
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(4) of subsection (r)) or by a qualified 
physical therapist (as defined in sub-
section (hhh))’’; and 
(II) by inserting ‘‘or a qualified 
physical therapist (as so defined)’’ 
after ‘‘physician’’ the second place it 
appears; 
(iv) in paragraph (4)(A)(ii), by strik-
ing ‘‘one or more physicians’’ and all that 
follows through ‘‘agency) and’’; and 
(v) by amending the fifth sentence to 
read as follows: ‘‘Nothing in this sub-
section shall be construed as authorizing 
the provision of services in a State that a 
qualified physical therapist is not author-
ized to provide in the State in accordance 
with State law (or the State regulatory 
mechanism provided by State law).’’ 
(B) CONFORMING AMENDMENTS.—Section 
1835(a)(2) of the Social Security Act (42 
U.S.C. 1395n(a)(2)) is amended— 
(i) in the matter preceding subpara-
graph (A), by inserting ‘‘, or in the case of 
outpatient physical therapy services (as de-
scribed in subparagraph (C)) and physical 
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therapy services furnished as comprehen-
sive outpatient rehabilitation facility serv-
ices (described in subparagraph (E)), a 
qualified physical therapist,’’ after ‘‘a phy-
sician’’; 
(ii) in subparagraph (C)— 
(I) in the matter preceding clause 
(i), by striking ‘‘or outpatient occupa-
tional therapy services’’; 
(II) in clause (i), by striking ‘‘or 
occupational therapy services, respec-
tively,’’ and inserting ‘‘, and’’; 
(III) in clause (ii), by striking 
‘‘or qualified occupational therapist, 
respectively,’’; and 
(IV) beginning in clause (ii), by 
striking ‘‘by a physician, and (iii)’’ 
and all that follows and inserting ‘‘by 
a physician or a qualified physical 
therapist;’’; 
(iii) in subparagraph (D)— 
(I) in the matter preceding clause 
(i), by striking ‘‘outpatient speech pa-
thology services’’ and inserting ‘‘out-
patient occupational therapy services 
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or outpatient speech-language pathol-
ogy services’’; 
(II) in clause (i), by striking 
‘‘needed speech pathology services’’ 
and inserting ‘‘needed occupational 
therapy services or speech-language 
pathology services, respectively’’; and 
(III) in clause (ii), by striking 
‘‘speech pathologist’’ and inserting 
‘‘occupational therapist or speech-lan-
guage pathologist, respectively,’’; and 
(iv) in subparagraph (E)— 
(I) in clause (ii), by inserting 
‘‘(or, in the case of comprehensive 
outpatient rehabilitation facility serv-
ices consisting of physical therapy 
services, by a qualified physical thera-
pist)’’ after ‘‘physician’’; and 
(II) in clause (iii), by inserting 
‘‘in the case of comprehensive out-
patient rehabilitation facility services 
not consisting of physical therapy 
services,’’ before ‘‘such services’’. 
(2) DEFINITION
OF
QUALIFIED
PHYSICAL 
THERAPIST.—Section 1861 of the Social Security 
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Act (42 U.S.C. 1395x) is amended by adding at the 
end the following new subsection: 
‘‘Qualified Physical Therapist 
‘‘(hhh) The term ‘qualified physical therapist’ means 
an individual who is licensed as a physical therapist by 
the State in which such individual is practicing and who 
meets the applicable requirements under paragraph (1) or 
(2): 
‘‘(1) With respect to individuals graduating 
from a professional physical therapy education pro-
gram on or after January 1, 2005, the individual— 
‘‘(A) has received a master’s or doctoral 
degree from a professional physical therapy 
education program that has been accredited by 
a national physical therapy education accredita-
tion agency recognized by the Secretary of Edu-
cation; or 
‘‘(B) has graduated from a professional 
physical therapy education program outside the 
United States with a curriculum that is sub-
stantially equivalent (as determined by an ac-
creditation agency described in subparagraph 
(A)) to the curricula of programs for profes-
sional physical therapy education programs in 
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vides the Secretary on a continuing basis with a sur-
ety bond that is not less than $50,000.’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to items and services furnished on 
or after January 1, 2010. 
Æ 
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