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North Carolina Physical Therapy Assistants

Definition of a PTA

"Physical therapist assistant" means any person who assists in the practice of physical therapy and who works under the supervision of a physical therapist by performing such patient-related activities assigned by a physical therapist which are commensurate with the physical therapist assistant's education and training, but an assistant's work shall not include the interpretation and implementation of referrals from licensed medical doctors or dentists, the performance of evaluations, or the determination or major modification of treatment programs.

What are PTAs allowed to do?

A physical therapist assistant may make modifications of treatment programs that are consistent with the established patient care plan. A physical therapist assistant may engage in off-site patient related activities that are appropriate for the physical therapist assistant's qualifications and the status of the patient.

What activities are expressly prohibited?

An assistant's may not interpret and implement referrals from licensed medical doctors or dentists, perform evaluations, or determine or make major modifications to treatment programs.

A physical therapist assistant shall not engage in practices requiring the knowledge and skill of a physical therapist.

A physical therapist assistant shall not engage in acts beyond the scope of practice delegated by the supervising physical therapist.

Can a PTA write a discharge summary or discharge from an episode of care?

No. Only a physical therapist may write a Discharge Evaluation Summary that includes a summary of the patient's progress toward meeting the established goals and the determination that treatment is to be discontinued. It would acceptable for a PTA to write a Brief Discharge Note (eg, A physical therapist evaluates a patient and writes a Discharge Evaluation Summary, but requests the PTA to see the patient for one or two more visits to complete a specific goal. After the PTA has seen the patient for 1 or 2 visits and the patient has met the goal, the PTA can write a Brief Discharge Note to that effect.)

Position Statement – NC Board of Physical Therapy Examiners

Approved at June 26, 2003 Board Meeting Updated January 19, 2010 Reviewed by the Board – September 23, 2010, June 17, 2015

What are the responsibilities of the PT when delegating to a PTA?

A physical therapist shall be immediately available in person or by telecommunication to a physical therapist assistant supervising a physical therapy aide or student engaging in patient care.

If a physical therapist assistant or physical therapy aide is involved in the patient care plan, a physical therapist shall reassess a patient every sixty (60) days or thirteen (13) visits, whichever occurs first.

What is the ratio between supervising PTs and PTAs?

A physical therapist shall clinically supervise only that number of assistive personnel, including physical therapist assistants, physical therapy aides, and students completing clinical requirements, as the physical therapist determines is appropriate for providing safe and effective patient interventions at all times.

Responsibilities of PTA when Delegating

A physical therapist assistant who is supervising a physical therapy aide or student must be present in the same facility when patient care is provided.

What must a PTA document?

The physical therapist assistant must document every intervention/treatment, which must include the following elements:

    • Authentication (signature and designation) by the physical therapist assistant who performed the service;
    • Date of the intervention/treatment;
    • Length of time of total treatment session;
    • Patient status report;
    • Changes in clinical status;
    • Identification of specific elements of each intervention/modality provided. Frequency, intensity, or other details may be included in the plan of care and if so, do not need to be repeated in the daily note;
    • Equipment provided to the patient or client; and
    • Response to treatment based on subjective and objective findings, including any adverse reactions to an intervention.

Can a PTA document this care without the co-signature of a therapist?

A physical therapist assistant may document care provided without the co-signature of the supervising physical therapist.


N.C. Gen. Stat. ยง 90-270.24

21 NCAC 48C .0201

21 NCAC 48C .0202

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