Texas Administrative Code
Title 22 - EXAMINING BOARDS
Part 16 - TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS
Chapter 322 - PRACTICE
Section 322.1 - Provision of Services
Universal Citation: 22 TX Admin Code ยง 322.1
Current through Reg. 49, No. 38; September 20, 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.
(b) Evaluation and screening.
(1) Evaluation.
Physical therapy treatment may not be provided prior to the completion of an
evaluation of the patient's condition by a PT.
(2) PTAs may screen patients designated by a
PT as possible candidates for physical therapy services. Screening entails the
collection of uniform information from all patients screened using a
predetermined, standardized format. The information collected is delivered to
the supervising PT. Only a PT may determine whether further intervention for
patients screened is necessary.
(c) Physical therapy plan of care development and implementation.
(1) The PT must develop a
written plan of care, based on his evaluation, for each patient.
(2) Treatment may not be provided by a PTA or
aide until the plan of care has been established.
(3) The plan of care must be reviewed and
updated as necessary following a reevaluation of the patient's
condition.
(4) The plan of care or
treatment goals may only be changed or modified by a PT.
(5) A PTA may modify treatment techniques as
indicated in the plan of care.
(6)
A PT or PTA must interact with the patient regarding his/her condition,
progress and/or achievement of goals during each treatment session.
(d) Reevaluation.
(1) Provision of physical therapy treatment
by a PTA or an aide may not continue if the PT has not performed a
reevaluation:
(A) at a minimum of once every
60 days after treatment is initiated, or at a higher frequency as established
by the PT; and
(B) in response to a
change in the patient's medical status that affects physical therapy treatment,
when a change in the physical therapy plan of care is needed, or prior to any
planned discharge.
(2) A
reevaluation must include:
(A) direct
physical therapist-to-patient interaction; and
(B) a review of the plan of care with
appropriate continuation, revision, or termination of treatment.
(e) Documentation of treatment.
(1) At a minimum, documentation of
physical therapy services must include the following:
(A) any referral authorizing
treatment;
(B) the initial
examination and evaluation;
(C) the
plan of care;
(D) documentation of
each treatment session by the PT or PTA providing the services;
(E) reevaluations as required by this
section;
(F) any conferences
between the PT and PTA, as described in this section; and
(G) the discharge summary.
(2) The PTA must include the name
of the supervising PT in his documentation of each treatment session.
(3) Physical therapy aides may not write or
sign any physical therapy documents in the permanent record. However, a
physical therapy aide may enter quantitative data for tasks delegated by the
supervising PT or PTA.
(4)
Discharge Summary. The PT must provide final documentation for discharge of a
patient, including patient response to treatment at the time of discharge and
any necessary follow-up plan. A PTA may participate in the discharge summary by
providing subjective and objective patient information to the supervising
physical therapist.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
