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Tennessee OT Thermal Agents

An authorization issued by the Board when a licensed occupational therapist or occupational therapy assistant has successfully completed requirements to use thermal agents, for which a federally required prescription is necessary, that include superficial heating agents (e.g., hot packs, paraffin), cryotherapy, and deep heating agents (e.g., ultrasound).

Thermal Agents Certification

To be eligible for certification in the use of thermal agents, an applicant must:

    • Meet all qualifications for licensure; and
    • Submit documentation of current certification from the Hand Therapy Certification Commission; or
    • Successfully complete Board-approved training that shall consist of a total of twenty (20) contact hours of didactic and laboratory experiences which include ten (10) treatments on clinical patients to be supervised by licensees who hold a thermal agents certification or by a physical therapist currently licensed in the United States. Five (5) of the ten (10) treatments shall utilize ultrasound. The treatments shall be from the following categories, and at least one (1) treatment shall be from each category:
      • Superficial heating agents
      • Cryotherapy
      • Deep heating agents

If an applicant is seeking certification in the use of physical agent modalities, the applicant shall present to the Board’s administrative office proof of successful completion of didactic and clinical training that has been completed within two (2) years preceding the submission of the application for certification.



The continuous supervision of fieldwork students who are training to be certified in the use of physical agent modalities is required at all times. Such supervision shall only be provided by an occupational therapist who is currently licensed in Tennessee and is currently certified in Tennessee in the use of physical agent modalities.

    • Approval of all training courses shall be made by the Board. The required training for electrical stimulation and thermal agents certification may be obtained through:
      • Colleges and universities approved for training occupational therapists and occupational therapy assistants by the American Occupational Therapy Association, or physical therapists and physical therapy assistants by the American Physical Therapy Association, or at clinical facilities affiliated with such accredited colleges or universities; or
      • The American Society of Hand Therapists; or
      • Any approved provider offering a Board-approved course.

The training for the therapeutic use of thermal agents shall provide competency in the following areas:


    • The expected outcome or treatments with thermal agents must be consistent with the goals of treatment.
    • Treatment with thermal agents must be safe, administered to the correct area, and be the proper dosage.
    • Treatment with thermal agents be adequately documented.


    • Ability to describe the physiological effects of thermal agents as well as differentiate tissue responses to the various modes of application.
    • Ability to select the appropriate thermal agent considering the area and conditions being treated.
    • Ability to describe equipment characteristics, indications, and contraindications for treatment, including identifying source and mechanisms of generation of thermal energy and its transmission through air and physical matter.

Preparation for Treatment

    • Ability to prepare the patient for treatment through positioning and adequate instruction.
    • Ability to explain to the patient the benefits expected of the thermal treatment.

Determination of Dosage

Ability to determine dosage through determination of target tissue depth, stage of the condition (acute vs. chronic), and application of power/dosage calculation rules as appropriate.

Treatment Administration

Ability to administer treatment through identification of controls, sequence of operation, correct application techniques and application of all safety rules and precautions.

Documentation of Treatments

Ability to document treatment including immediate and long-term effects of thermal agents.


Tenn. Comp. R. & Regs. 1150-02-.01

Tenn. Comp. R. & Regs. 1150-02-.04

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