Practicing in USA with Foreign Education

Original Editor - User Name Top Contributors - Jeremy Bryan, Siobhán Egan, Sinéad Delahunty and Kim Jackson

Introduction[edit | edit source]

In order to practice Physical Therapy in the United States (US), a license is required. A license is specific to the state for which the Physical Therapist is going to practice and it ensures a minimum competency level to safely provide Physical Therapy care.

The most common path to obtaining a license is by graduating from a CAPTE (Commission on Accreditation in Physical Therapy Education) accredited Physical Therapy program and then passing the NPTE (National Physical Therapy Exam).[1]

There is currently only one Physical Therapy program outside of the US that is CAPTE accredited. It is the Doctorate of Physiotherapy program at Robert Gordon University in Aberdeen, Scotland.[2] However, there are provisions for obtaining a license if the Physical Therapist was educated at another Physical Therapy program outside the US.

Additionally, if the Physical Therapist is not a US citizen or does not possess a permanent resident (green) card, there are also US Citizenship and Immigration Services (USCIS) requirements to be able to work in the US.

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Non US Citizen or Non Permanent Resident[edit | edit source]

If a Physical Therapist is not a US citizen or does not possess a permanent resident (green) card, the first step is to obtain a health care worker certification.

Health care worker certifications ensure that the the Physical Therapist meets minimum standards for education, training, experience, English language fluency, and finally licensure.[4]

  • Education, training, and experience - must be verified as being at a similar level as the requirements placed on current US Physical Therapists.[4]
    • Evaluation is based on the Federation of State Boards of Physical Therapy (FSBPT) Coursework Tools.
    • The version of the Coursework Tools used is based on the year a Physical Therapist graduated from their Physical Therapy program.
  • English language fluency - demonstrate ability to speak and write in English though the passing of a nationally recognized standardized test.[4]
  • Licensure - Pass the NPTE.[4]


Health care worker certifications can be issued from one of the following approved agencies:


Once a health care worker certification is obtained, a Visa must also be granted. Common Visas that a non citizen or non permanent resident Physical Therapist might be granted include:

  • H-1B: Temporary employment in a specialty occupation requiring a Bachelors degree or greater.[5]
  • EB2: Permanent worker with advanced degree, offers path to green card.[5]
  • EB3: Permanent worker in skilled profession, offers path to green card.[5]


With a Health Care Workers Certification and the correct Visa, the Physical Therapist would be able to practice in the US, in the specific state they became licensed in.

US Citizen or Permanent Resident[edit | edit source]

For foreign educated Physical Therapists who are US citizens or permanent residents, obtaining a license is the most important step toward being able to practice in the US.

Ultimately, just as for Physical Therapists who graduated from a CAPTE accredited Physical Therapy program, each state dictates the requirements for granting a license to foreign educated Physical Therapists.

Physical Therapists who are US citizens or permanent residents seeking licensure must have their Physical Therapy education evaluated and approved by a credentialing agency using the FSBPT Coursework Tool.[6] Credentialing agencies approved to use the Coursework Tool include:


Once the Physical Therapist has had their education approved, they can sit for the NPTE. Passing the NPTE is required for licensure in every state.

Depending on the chosen state of licensure, there can be additional requirements that the Physical Therapist must meet. These requirement may include:

  • Passing a test of English language proficiency[7]
  • Performing a certain amount of supervised clinical practice[7]
  • Passing a rules and regulations exam[7]
  • Passing a criminal background check[7]
  • Possessing professional liability insurance[7]
  • Possessing proof of meeting requirements to practice in country of education[7]
  • Possessing proof of right to work in US[7]


Once all requirements have been satisfied, a license will be granted and and Physical Therapist will be able to practice in the state for which the license applies.

Useful Websites[edit | edit source]

References[edit | edit source]

  1. American Physical Therapy Association. About PT and PTA Licensure. Available at https://www.apta.org/your-practice/licensure/pt-and-pta-licensure (accessed on 18 Feb, 2023)
  2. Commission on Accreditation in Physical Therapy Education. Education Outside the US. Available from https://www.capteonline.org/programs/foreign-educated-pts (Accessed on 19 Feb, 2023)
  3. Physio trendz. Process To Become Licensed Physical Therapist In USA |FCCPT |FSBPT |NPTE. Available from: https://www.youtube.com/watch?v=eEx3O0jOfIs [last accessed 1/10/2022]
  4. 4.0 4.1 4.2 4.3 4.4 4.5 US Citizenship and Immigration Services. Health Care Workers Certification. Available from https://www.uscis.gov/working-in-the-united-states/temporary-workers/health-care-worker-certification (accessed on 19 Feb, 2023)
  5. 5.0 5.1 5.2 Federation of State Boards of Physical Therapy. Foreign Educated Physical Therapists. Available from https://www.fsbpt.org/Free-Resources/Foreign-Educated-PTs-and-PT-Assistants/Immigration-Information (accessed on 19 Feb, 2023)
  6. 6.0 6.1 6.2 6.3 Federation of State Boards of Physical Therapy. Coursework Tools for Foreign Educated PTs and PTAs. Available at https://www.fsbpt.org/Free-Resources/Regulatory-Resources/Coursework-Tools-CWT (accessed on 19 Feb, 2023)
  7. 7.0 7.1 7.2 7.3 7.4 7.5 7.6 The Federation of State Boards of Physical Therapy. Jurisdiction Licensure Reference Guide Topic: Requirements for Licensure by Examination (Foreign Educated). Available at https://www.fsbpt.net/lrg/Home/LicensureByExamNonCapteRequirement (Accessed on 19 Feb, 2023)