USA (Physical Therapy)

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Original Editor - Jeremy Bryan

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Patient Access to Physical Therapy Services / Entry Point

In the United States there are two ways to gain access to Physical Therapy services, by referral of by direct access. By referral is the traditional method and it means that a physician, surgeon, nurse practitioner, or physician's assistant writes a prescription for Physical Therapy services. By direct access means going directly to a Physical Therapist without meeting with another clinician for a prescription.

Currently, all fifty states, the District of Columbia, and the US Virgin Islands allow direct access in some form. Each specific state stipulates their own parameters of direct access.

According to the American Physical Therapy Association, as of February of 2021, there were 20 states that allowed direct access with no parameters or restrictions, 27 states, along with the District of Columbia and the US Virgin Islands, that allowed direct access with some form of parameters or restrictions, and three states that allowed direct access only under specific circumstances.

Therapist Preparation

In order to practice Physical Therapy in the United States, a license is required for each state where the Physical Therapist practices.

In order to be granted a license, a candidate must:

Obtained a Doctor of Physical Therapy (DPT) degree from a Commission on Accreditation in Physical Therapy Education (CAPTE) accredited Physical Therapy program.

OR

Have international Physical Therapy education reviewed and approved by an acceptable credentialing agency.

AND

Pass the National Physical Therapy Examination (NPTE).

AND

Meet any additional state specific requirements such as the passing of a rules and regulations examination.

Degree/Credentialing

Currently, the standard for Physical Therapy education in the United States is a Doctor of Physical Therapy (DPT) degree.As of January 2016, only programs which confer a Doctor of Physical Therapy (DPT) degree can become CAPTE accredited.

Because a Doctor of Physical Therapy (DPT) degree did not become the standard until 2016, it is still common to find Physical Therapists within the workforce with Masters or Bachelors level Physical Therapy educations.

Specialization

Physical Therapists can pursue further education through residencies, fellowships, and certifications.

Residencies and fellowships are accredited through the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE).

Certifications are offered through various entities such as the American Physical Therapy Association.

Residencies

Residencies allow a Physical Therapist to gain further education and experience in a specific clinical area.

ABPTRFE accredited residencies currently include programs in the clinical areas of:

• Orthopedics
• Sports
• Acute Care
• Cardiovascular and Pulmonary
• Clinical Electrophysiology
• Geriatrics
• Pediatrics
• Neurology
• Oncology
• Wound Management
• Women's Health

Residencies can prepare a Physical Therapist to sit for board certification in a specific clinical area. Board certification is offered through the American Board of Physical Therapy Specialties in the following clinical areas:

• Orthopedics
• Sports
• Cardiovascular and Pulmonary
• Clinical Electrophysiology
• Geriatrics
• Pediatrics
• Neurology
• Oncology
• Wound Management
• Women's Health

Fellowships

Fellowships offer further education in the clinical area for which a Physical Therapists has graduated from a residence program or has been board certified.

ABPTRFE accredited fellowships include programs in the following clinical areas:

• Sports Division 1
• Upper Extremity Athlete
• Performing Arts
• Orthopaedic Manual Physical Therapy

• Hand Therapy
• Spine
• Critical Care
• Neonatology

Certifications

There are numerous certifications that a Physical Therapist can obtain, spanning many different areas of practice.

Below are some examples of common certifications:

• CHT or Certified Hand Therapist - Hand Therapy Certification Commission
• CLT or Certified Lymphedema Therapist - Lymphedema Association of North America