                                 CODE OF VIRGINIA

PRACTICE OF PHYSICAL THERAPY; CERTAIN EXPERIENCE AND REFERRALS REQUIRED;
PHYSICAL THERAPIST ASSISTANTS (§ 54.1-3482)

A. It shall be unlawful for a person to engage in the practice of physical
therapy except as a licensed physical therapist, upon the referral and direction
of a licensed doctor of medicine, osteopathy, chiropractic, podiatry, or dental
surgery, a licensed advanced practice registered nurse practicing in accordance
with the provisions of &#xA7; 54.1-2957, or a licensed physician assistant
acting under the supervision of a licensed physician, except as provided in this
section.

B. A physical therapist who has completed a doctor of physical therapy program
approved by the Commission on Accreditation of Physical Therapy Education or who
has obtained a certificate of authorization pursuant to &#xA7; 54.1-3482.1 may
evaluate and treat a patient without a referral under the following conditions:
(i) the patient is not receiving care from any licensed doctor of medicine,
osteopathy, chiropractic, podiatry, or dental surgery, a licensed advanced
practice registered nurse practicing in accordance with the provisions of &#xA7;
54.1-2957, or a licensed physician assistant acting under the supervision of a
licensed physician for the symptoms giving rise to the presentation at the time
of the presentation to the physical therapist for physical therapy services or
(ii) the patient is receiving care from a licensed doctor of medicine,
osteopathy, chiropractic, podiatry, or dental surgery, a licensed advanced
practice registered nurse practicing in accordance with the provisions of &#xA7;
54.1-2957, or a licensed physician assistant acting under the supervision of a
licensed physician at the time of his presentation to the physical therapist for
the symptoms giving rise to the presentation for physical therapy services and
(a) the patient identifies a licensed doctor of medicine, osteopathy,
chiropractic, podiatry, or dental surgery, a licensed advanced practice
registered nurse practicing in accordance with the provisions of &#xA7;
54.1-2957, or a licensed physician assistant acting under the supervision of a
licensed physician from whom he is currently receiving care; (b) the patient
gives written consent for the physical therapist to release all personal health
information and treatment records to the identified practitioner; and (c) the
physical therapist notifies the practitioner identified by the patient no later
than 14 days after treatment commences and provides the practitioner with a copy
of the initial evaluation along with a copy of the patient history obtained by
the physical therapist.

C. A physical therapist who has not completed a doctor of physical therapy
program approved by the Commission on Accreditation of Physical Therapy
Education or who has not obtained a certificate of authorization pursuant to
&#xA7; 54.1-3482.1 may conduct a one-time evaluation that does not include
treatment of a patient without the referral and direction of a licensed doctor
of medicine, osteopathy, chiropractic, podiatry, or dental surgery, a licensed
advanced practice registered nurse practicing in accordance with the provisions
of &#xA7; 54.1-2957, or a licensed physician assistant acting under the
supervision of a licensed physician; if appropriate, the physical therapist
shall immediately refer such patient to the appropriate practitioner.

D. Invasive procedures within the scope of practice of physical therapy, except
for the practice of dry needling, shall at all times be performed only under the
referral and direction of a licensed doctor of medicine, osteopathy,
chiropractic, podiatry, or dental surgery, a licensed advanced practice
registered nurse practicing in accordance with the provisions of &#xA7;
54.1-2957, or a licensed physician assistant acting under the supervision of a
licensed physician. Nothing in this section shall be construed to authorize a
physical therapist in the practice of dry needling to fail to comply with the
provisions of &#xA7; 54.1-2956.9.

E. It shall be unlawful for any licensed physical therapist to fail to
immediately refer any patient to a licensed doctor of medicine, osteopathy,
chiropractic, podiatry, or dental surgery, or a licensed advanced practice
registered nurse practicing in accordance with the provisions of &#xA7;
54.1-2957 when such patient&#8217;s medical condition is determined, at the time
of evaluation or treatment, to be beyond the physical therapist&#8217;s scope of
practice. Upon determining that the patient&#8217;s medical condition is beyond
the scope of practice of a physical therapist, a physical therapist shall
immediately refer such patient to an appropriate practitioner.

F. Any person licensed as a physical therapist assistant shall perform his
duties only under the direction and control of a licensed physical therapist.

G. However, a licensed physical therapist may provide, without referral or
supervision, physical therapy services to (i) a student athlete participating in
a school-sponsored athletic activity while such student is at such activity in a
public, private, or religious elementary, middle or high school, or public or
private institution of higher education when such services are rendered by a
licensed physical therapist who is certified as an athletic trainer by the
National Athletic Trainers&#8217; Association Board of Certification or as a
sports certified specialist by the American Board of Physical Therapy
Specialties; (ii) employees solely for the purpose of evaluation and
consultation related to workplace ergonomics; (iii) infants and toddlers, from
birth to age three, who require physical therapy services to fulfill the
provisions of their individualized services plan under Part C of the Individuals
with Disabilities Education Act (20 U.S.C. &#xA7; 1431 et seq.) and students
with disabilities who require physical therapy services to fulfill the
provisions of their individualized education plan or physical therapy services
provided under &#xA7; 504 of the federal Rehabilitation Act of 1973 (29 U.S.C.
&#xA7; 794 et seq.); (iv) the public for the purpose of wellness, fitness, and
health screenings; (v) the public for the purpose of health promotion and
education; and (vi) the public for the purpose of prevention of impairments,
functional limitations, and disabilities.

HISTORY: 2000, c. 688; 2001, c. 858; 2002, cc. 434, 471; 2003, c. 496; 2005, c.
928; 2007, cc. 9, 18; 2015, cc. 724, 746; 2018, c. 776; 2021, Sp. Sess. I, c.
481; 2023, cc. 136, 137, 183.