While we always prefer to have a script from a physician on file, the state of Virginia does allow patients to be seen by their physical therapist without one. Here at The Gait Center, we do REQUIRE that if a script is not provided, the patient MUST identify a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed nurse practitioner, or a licensed physician assistant. Patients cannot be treated until this information is provided.
So what exactly is Direct Access? In 2001 the Virginia General Assembly passed a law to allow physical therapists to legally see a patient without an order/script from a physician. There have been revisions to the law in 2007, 2015, 2021, and 2023 expanding access to give patients more freedom to seek medical care where they so choose. There are important guidelines to keep in mind, such as time and visit limits.
1. Direct Access is only allowed for 30 consecutive days for Medicare Patients, and 60 consecutive days for Commercial Insurance Patients: The initial evaluation must be sent to the practitioner identified by the patient within 14 days of the initial evaluation. This must be reviewed, signed, and faxed back to our office – approving continuation of treatment. The initial evaluation will be faxed after the first visit, per our standard procedures.
2. A physical therapist shall not perform a “direct access initial evaluation” of a patient if the physical therapist has previously performed an initial evaluation of the patient for the same condition within the immediately preceding 60 days.
3. A physical therapist who has not completed a doctor of physical therapy program or who has not obtained a certificate of authorization pursuant to Section 54.1- 3482.1 may conduct a one-time evaluation of a patient, but provide no further treatment, without a referral. The initial evaluation will be faxed after the first visit, per our standard procedures.
Physical therapists complete extensive education and specific training in a doctoral program, or through required advanced training, to be able to determine whether or not your problem is truly due to a musculoskeletal condition. If the therapist determines that your condition is beyond the scope of physical therapy care, they will refer you to the appropriate medical professional.
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