I 
108TH CONGRESS 
1ST SESSION 
H. R. 792
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 
FEBRUARY 13, 2003
Mr. CRANE (for himself, Mr. POMEROY, Mr. ABERCROMBIE, Mr. BOEHNER, 
Mrs. CAPPS, Mr. LINCOLN DIAZ-BALART of Florida, Mr. ENGLISH, Mrs. 
EMERSON, Mr. ETHERIDGE, Mr. FARR, Mr. GRAVES, Mr. LATHAM, Mr. 
LEACH, Mr. LYNCH, Mr. MARKEY, Mr. GARY G. MILLER of California, 
Mr. MCNULTY, Mr. PAUL, Mr. TOWNS, Mr. YOUNG of Alaska, Mr. KIL-
DEE, and Mr. FROST) introduced the following bill; which was referred 
to the Committee on Energy and Commerce, and in addition to the Com-
mittee on Ways and Means, for a period to be subsequently 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.
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 2003’’. 
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 
(4) of subsection (r)) or by a qualified 
physical therapist (as defined in sec-
tion 1861(ww))’’; 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’’ 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 
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 
or outpatient speech-language pathol-
ogy services’’;