How to Start a Direct Access Physical Therapy Practice

PTs, learn the 4 steps to starting a direct access physical therapy practice.

You’re a PT. You have a booming clinic. So, why should you care about having a direct access physical therapy practice? For one, breaking free of the doctor dependence is liberating! You can take control of your own practice growth. Additionally, the APTA reports direct access gives PTs more autonomy as it grants the opportunity to:

• Develop relationships with other healthcare professionals.
• Be more competitive in “referral for profit” markets.
• Take more responsibility for clinical decisions related to your patients’ physical therapy protocols.
• Offer cash-based services to lessen the impact of declining insurance reimbursement in the areas such as prevention and fitness.
• Save your patients’ time and money by reducing the need for unnecessary referrals.
• Improve your patients’ access to physical therapy treatment.

Starting Your Direct Access Physical Therapy Practice

Here are 4 steps to building your direct access PT practice:

1. Check your state guidelines for direct access PT.

First, view the APTA’s “Levels of Patient Access to PTs in the US" here. Note the provisions or limitations in your practice state. Limitations at the state level include:

• Unrestricted Access: As the word suggests, there are no restrictions to access physical therapy services. There are a total of 18 states in the US that allow unrestricted access to physical therapy services.
• Patient Access with Provision: There are 26 states, DC, & US Virgin Islands that allow access to evaluate and treat with some provisions or restrictions. Examples of restrictions include limits on the numbers of visits or limits on visit time.
• Limited Access: This means that access to physical therapy services are limited to evaluation only. Or, it may be limited to treatment of certain patient populations or under certain diagnoses. There are 6 states with limited patient access to physical therapy services.

In addition, be sure to check the managed care and insurance contracts you currently have established within your practice. If necessary, you can contact insurance providers on a case-by-case basis and verify reimbursement for PT evaluation and treatment.

Remember, direct access does not mean that your PT evaluations and re-certifications do not have to be signed by a physician. It means you do not need a physician referral to initiate a PT treatment. So, make sure you still continue to follow protocols to have your plan of care signed by a physician.

2. Offer Cash-Based Services.

One of the great benefits of direct access is the ability to offer cash-based services. You can collect cash for services without the threat of insurance denials. This includes services provided for prevention, fitness, and health promotion. If you decide to start your cash-based practice, make sure to provide a summary of your evals and treatments to your patients, and keep copies for your records.

3. Market your practice.

First, map out a strategy on how you plan to provide direct access physical therapy services. For example, you can begin to offer programs that were previously limited to physician referral requirements.

Next, start marketing your direct access PT practice. Let your clients know that they can see you directly for musculoskeletal services without a physician’s referral:

• Place the information about direct access PT on your company’s website.
• Hang a poster about direct access and its benefits in the waiting area of your clinic.
• Pass out brochures to your current patients and potential clients.
• Post on social media about how you can provide PT services without a physician’s referral.

Try to be creative… and have fun! Your ability to think outside of the box will determine your success.

4. Take continuing education courses to maintain your direct access status.

Many state PT boards require direct access continuing education to include CEUs on the topics of evaluative procedures and differential diagnoses. To view direct access CEUs, click here.