Physical Therapy Prescription
Introduction[edit | edit source]
A physical therapy prescription, sometimes called an order or a referral, is a written or electronic document, from a specific medical professional, authorizing the the need for a physical therapy evaluation and or treatment.
Prescription refers to a written order from health professional to a patient. It is one of the significant steps in patient management. The word prescription originates from Latin “pre” meaning before and “scribe” meaning writing.
Physical therapy care can currently be received in many areas via direct access, without the need for a physical therapy prescription. However, local regulations as well as insurance requirements still often require a physical therapy prescription under certain circumstances.
The prescription should be always on the letter head of the doctor. It should mention the doctor’s name, address of the clinic, educational degree of the doctor, registration details, contact details and logo.
Components of a Physical Therapy Prescription[edit | edit source]
Prescription formats can vary widely, but usually include the following information:
- Name, Age, Date of Birth of the patient
- One or more International Classification of Diseases diagnosis code(s), associated with the need for physical therapy treatment
- A written explanation of the chief complaint or reason for the need for physical therapy intervention
- Recommended frequency of treatment
- Authorized length of the plan of care
- Name, signature, and license or identification number of medical practitioner authorizing care
- Name of clinic or institution medical practitioner is associated with, if applicable
- Contact information of medical practitioner
Table 1 shows Summary Components of a Physical Therapy Prescription[edit | edit source]
Table 2 shows general algorithm for prescribing physical therapy interventions to treat musculoskeletal injury . however individual prescriptions are based on the patient’s specific condition and comorbidities and on the availability of modalities.
|Acute (< 72 hours)||Subacute (Three to 14 days)||Chronic (> Two weeks)|
Sometimes a prescription will only be for a physical therapy evaluation, but no treatment. In this case, the physical therapy evaluation will be performed and the documentation will be sent back to the medical professional who wrote the prescription, who will then decide whether or not to write a new prescription for further physical therapy treatment.
Sample of Therapy Prescription[edit | edit source]
Table 3 shows a sample of Physical Therapy Prescription[edit | edit source]
|Name with identifying factors: (e.g., DOB)
Discipline: PT, OT, or other
Diagnosis or diagnoses:
Frequency of visits: such as 2 to 3x/week.
Duration of treatment: such as 3 to 4 weeks; or 8 to 12 total visits used at the therapist’s discretion
Therapeutic modalities: such as heat or cold packs, electrical stimulation
Manual therapy: such as MFR, massage, or joint mobilization
Therapeutic exercise: such as active, active assisted, and passive range of motion (A/ AA/PROM), stretching, strengthening/ PREs, balance/proprioceptive training, neuromuscular reeducation, or conditioning exercises
Specialized treatments: kinesiology taping, aquatic therapy, or kinetic chain analysis
Patient education: such as written home exercise program , ergonomic advice if needed, functional activities do and don't
Goals: such as decreasing pain and swelling, restoring ROM/flexibility than strength, or safely returning to functional activities (e.g., sports, hobbies, and work)
Reevaluation: such as 3 to 4 weeks by referring physician
Warning signs or when to contact a Physiotherapist: eg: during post-operative physiotherapy, while performing a home exercise program if oozing (bleeding)comes out
Referring Practitioners[edit | edit source]
In most cases, in order for a physical therapy prescription of be accepted by a Physical Therapist, it must come from one of a few types of medical professionals. Generally, acceptable medical professionals are included below. However, local regulations may include some, all, or more than those listed.
- Osteopathic Physicians
- Physician Assistants
- Advanced Registered Nurse Practitioners
Direct Access[edit | edit source]
Direct access means being able to receive physical therapy services without a physical therapy prescription.
According to Piscitelli, Furmanek, Meroni, De Caro, and Pellicciari, a 2012 survey indicated that direct access to physical therapy services were available in 40 different countries.
In the United States, 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.
References[edit | edit source]
- Dyasanoor, Sujatha, and Ayeesha Urooge. “Insight Into Quality of Prescription Writing - An Instituitional Study.” Journal of clinical and diagnostic research : JCDR vol. 10,3 (2016): ZC61-4.doi:10.7860/JCDR/2016/18011.7472
- Rand SE, Goerlich C, Marchand K. The physical therapy prescription. American Family Physician. December 2007.
- Malhotra G, Wyss JF, Patel AD. Guide to Therapy Prescription Writing. Wyss_PTR_CH07_30-11-12_2012 35-38.indd
- Piscitelli, Furmanek, Meroni, De Caro, and Pellicciari. Direct access in physical therapy: a systematic review. Clin Ter. 2018; 169 (5):e249-260.
- The Physical Therapy and Wellness Channel. Do I Need A Referral For Physical Therapy?. Available from: https://www.youtube.com/watch?v=gU5UahNe4VI [last accessed 5/32/2023]
- American Physical Therapy Association. Levels of Patient Access to Physical Therapist Services in the U.S. Available from https://www.choosept.com/globalassets/choosept/assets/pdf-downloadables/direct-access-by-state-map.pdf (accessed 30 May, 2023)