Texas Administrative Code › Title 22 - EXAMINING BOARDS › Part 16 - TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS › Chapter 322 - PRACTICE › Section 322.1 - Provision of Services

Current through Reg. 49, No. 28; July 12, 2024
(a) Initiation of
				physical therapy services.
(1) Referral
				requirement. Except as authorized by paragraph (2) of this subsection, a
				physical therapist is subject to discipline from the board for providing
				physical therapy treatment without a referral from a qualified healthcare
				practitioner licensed by the appropriate licensing board, who within the scope
				of the professional licensure is authorized to prescribe treatment of
				individuals. The list of qualifying referral sources includes physicians,
				dentists, chiropractors, podiatrists, physician assistants, and advanced nurse
				practitioners.
(2) Exceptions to
				referral requirement.
(A) A PT may evaluate
				without referral.
(B) A PT may
				provide instructions to any person who is asymptomatic relating to the
				instructions being given without a referral, including instruction to promote
				health, wellness, and fitness.
(C)
				Emergency Circumstances. A PT may provide emergency medical care to a person
				after the sudden onset of a medical condition manifesting itself by acute
				symptoms of sufficient severity without referral if the absence of immediate
				medical attention could reasonably be expected to result in a serious threat to
				the patient's health, serious impairment to bodily functions, or serious
				dysfunction of any bodily organ or part.
(D) A PT may treat a patient for an injury or
				condition without a referral for not more than 10 consecutive business days if
				the PT:
(i) has been licensed to practice
				physical therapy for at least one year;
(ii) is covered by professional liability
				insurance in the minimum amount of $100,000 per claim and $300,000 aggregate
				per year; and
(iii) either:
(I) possesses a doctoral degree in physical
				therapy from:
(-a-) a program that is
				accredited by the Commission on Accreditation in Physical Therapy Education;
				or
(-b-) an institution that is
				accredited by an agency or association recognized by the United States
				secretary of education; or
(II) has completed at least 30 CCUs in the
				area of differential diagnosis.
(E) A PT may treat a patient for an injury or
				condition without a referral for not more than 15 consecutive business days if
				the PT possesses a doctoral degree as described in subparagraph
				(D)(iii)(I)(-a-) or (-b-) of this paragraph and has satisfied the conditions
				set forth in subparagraph (D)(i) and (ii) of this paragraph, and either:
(i) has completed a physical therapy
				residency or fellowship; or
(ii) is
				certified by an entity approved by the board. The board will maintain a list of
				approved entities on its website.
(F) A PT must obtain a referral from a
				qualified healthcare practitioner before continuation of treatment that exceeds
				that which is authorized in subparagraph (D) or (E) of this
				paragraph.
(G) A PT who treats a
				patient without a referral under subparagraph (D) or (E) of this paragraph must
				obtain a signed disclosure on a form prescribed by the board prior to the
				initiation of treatment. The disclosure form will be made available on the
				board's website.
(3)
				Methods of referral. A referral may be transmitted by a qualifying referral
				source in the following ways:
(A) in a written
				document, including faxed and emailed documents; or
(B) verbally, in person or by telephone. If a
				referral is transmitted verbally, whether in person or by telephone, it must be
				received, recorded and signed by the PT, PTA or other authorized personnel, and
				include all of the information that would appear on a written
				referral.