➤ Direct Access FAQ
What are the current direct access laws in Virginia?The Board of Physical Therapy has developed a “Patient Attestation and Medical Release Form” for use by the PT to document the patient meets the requirements under this portion of the direct access law.
- This form is available here.
- If a clinical facility chooses not to use this form the information on the form must all be included in the patient record as determined by the clinical facility.
One time Evaluation only, no treatment, without a direct access certification:
A licensed PT does not need to apply for the certification process if he/she only wishes to perform an initial evaluation on a patient as described under our current law. This clause in the law also provides a mechanism for the PT to evaluate a patient who does not meet the conditions noted in the paragraph above. The PT can at least evaluate the patient and then contact the practitioner for a referral as you do now.
Other direct access areas available to any licensed PT in Virginia, without the need for a direct access certification:
- a student athlete participating in a school-sponsored activity if the PT is an ATC or SCS
- [the] employees solely for the purposes of evaluation and consultation related to workplace ergonomics
- special education students under an IEP
- the public for the purpose of health promotion and wellness, fitness, and health screening and prevention.
If I don’t apply for the certification can I still see patients with a previous diagnosis?
No, that portion of the previous law was changed in 2007 and the previous diagnosis clause was removed. In its place is the new language that requires the certification to evaluate and treat a patient for 14 business days. The one time evaluation language remains in the law – your only option at that point with no certification would be to complete a one- time evaluation and then call the practitioner to garner a referral.
Do I have to develop a patient attestation form to use with the direct access patients?
- No, the Board of Physical Therapy has already done that and it is posted online at: HERE
Do I need a direct access certification?
If you have an entry-level Doctor of Physical Therapy degree from a CAPTE accredited program, you do not need a direct access certification.
If you have received a transitional Doctor of Physical Therapy degree, you will apply for a one-time direct access certification.
If you do not have the DPT or tDPT degrees, you need to apply with the Board of Physical Therapy for a direct access certification.
How do I get my direct access certification? Is there a form I need to use?
- This is an ongoing process. You can apply at any time for the certification. There are currently over 700 licensed physical therapists in Virginia with the direct access certification.
You must first determine if you are currently eligible to apply for a certificate of direct access. To do so you must meet one of the following:
Be a Physical Therapist who has 1) an entry level doctor of physical therapy degree (DPT), 2) a transitional doctor of physical therapy degree, or 3) completed continuing education in the area of differential diagnosis and medical screening for at least 15 contact hours and complete a test showing competency of that material.
If you are eligible then go to the Department of Health Professions website and download the form and complete it and send it in with your payment. You will then be issued a certificate.
Do I need to renew my direct access certification?
No, certification is a one-time process and does not need to be renewed.
Location of Form for Direct Access Certification:
- The application fee for the initial certification process for those applying with a transitional or with experience is $75.00.
If I do not have an entry-level DPT or a transitional DPT and have not completed the continuing education needed how can I get a direct access certification? What are my options?
Option 1 – Complete a face-to-face continuing education course that is at least 15 hours in length related to medical screening and differential diagnosis for physical therapy. This course must include a post-test of content mastery. Proof of completion certificate is required.
Option 2 – Complete an online college course or continuing education course with focus on medical screening and differential diagnosis that includes a post-test for mastery. There must be at least 15 contact hours for the course, typically a 1 credit or more college based course.
Does a physical therapist assistant have to apply for direct access certification also?
No, the PTA is under the direction and supervision of the PT who evaluated that patient. It is the responsibility of the PT to evaluate a patient under the current direct access law, determine a plan of care, and then decide if a PTA will be assisting in the delivery of specific interventions within the plan of care. As is the case for any patient, the PT should remain actively involved in the care of the patient seen under direct access.
Do insurance companies reimburse differently for patients seen under direct access?
If you are seeing a patient under the new direct access law you should contact the patient’s insurer and determine their level of coverage. Many PT’s in Virginia using the new law report that the insurance company will reimburse at the same rate as when a referral is utilized. However, some insurers, as per the contract you negotiate with them and the contract they negotiate with an employer, require in that contract a physician referral for coverage. If that is the case they will not cover patients under direct access. If the issue is silent in the contract they may cover it since it is now allowable by law. If the contract is a problem we suggest you ask that the referral clause be removed when you renegotiate your contract with that provider. Also remember that a patient can self-pay for services provided by a PT so that is certainly an option if there is a barrier from the insurer.
How do I renew my direct access certification and what is required to do so?
In order to renew a direct access certification a licensee shall be required to: 1) hold an active, unrestricted license as a physical therapist and comply with the continuing education requirements as follows:
Physical therapists holding certification to provide direct access without a referral shall include 4 contact hours related to carrying out direct access duties as part of the required 30 contact hours of continuing education. Courses for direct access continuing education shall relate to clinical practice in a direct access setting.
This means that you will not be required to garner additional hours of continuing education, but you should include some continuing education courses that are clinical in nature and address in some way aspects of practicing in a direct access setting (i.e. – safe practice, differential diagnosis, medical screening, assessment of patients in direct access, etc) They may not necessarily be separate courses but may be content included in a broader clinical course. The course syllabus should reflect some of these aspects in the objectives so that you can provide evidence of meeting this requirement.