Direct Access to Physical Therapy in the U.S.

Physical therapy direct access treatment physician's referral

Direct access in the United States gives you the ability to see a physical therapist without the need for a physician referral. All 50 states (plus Washington DC) have some form of direct access, though some states may have provisions related to time and specific types of injuries. Direct access gives you control over how and where you receive care, leaving the decision of which physical therapist you see solely up to you. It can also help to reduce treatment delays if you choose to go straight to a PT, saving you time and money.

Start With Physical Therapy First

Sometimes it’s difficult to know where to start with healthcare. Most people think they need to go to their primary care doctor first before getting referred out to other specialists. However, if you experience any musculoskeletal injury—for example low back pain, ankle sprains, shoulder, neck or back strains, etc.—your PT can be your go-to to assess your injury, provide treatment or, if needed, refer you to the appropriate provider. A good PT will ask all of the right questions to rule out anything that’s not musculoskeletal. If it’s not musculoskeletal-related, your physical therapist has a network of specialists s/he can refer you out to.

Direct access laws can be broken up into three categories: Patient Access with Provisions, Unrestricted Patient Access and Limited Patient Access. See the map above to check your state’s Direct Access laws.

Direct Access laws can vary a great deal based on which state you’re seeking out physical therapy. Most states with provisions have rules about how long a PT can treat a patient before having to refer them to a primary care physician. For example, if you live in California, you can see a physical therapist for 45 days of treatment or 12 visits, whichever comes first, before needing to get a physician referral. State-to-state laws may differ but know that you can see a physical therapist directly if you are experiencing pain or injury.

The map below shows states in the U.S. with Direct Access time provisions, ie: the length of time you can receive PT treatment before a physician’s referral is required.

Physical therapy direct access time limit physician's referral physical therapist

For more detailed information on Direct Access laws for each state, visit:

Whether you’re in a provisions, limited or unrestricted state, just know that with Direct Access, you can receive some form of treatment by a physical therapist without needing a physician’s referral. If you’ve never been to physical therapy before, check out our blog What to Expect on Your First Visit to learn more.

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