Upcoming Webinars 


The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Log in

Log in

Texas Physical Therapy Referral Requirement

Is a referral required to provide PT services?

Yes. A physical therapist is subject to discipline from the board for providing physical therapy treatment without a referral from a qualified healthcare practitioner.

Exceptions to the referral requirement? Change September 2019

A physical therapist may treat a patient for an injury or condition without a referral if the physical therapist:

    • Has been licensed to practice physical therapy for at least one (1) year;
    • Is covered by professional liability insurance in the minimum amount of $100,000 per claim and $300,000 aggregate per year; and
    • Either:
      • Possesses a doctoral degree in physical therapy
        • a program that is accredited by the Commission on Accreditation in Physical Therapy Education; or
        • an institution that is accredited by an agency or association recognized by the United States secretary of education; or
      • Has completed at least thirty (30) hours of continuing competence activities in the area of differential diagnosis.

Limitation on the number of days that a PT may treat a patient without a referral

A physical therapist may treat a patient for up to ten (10) consecutive business days without a referral.

A physical therapist who possesses a doctoral degree and has completed a residency or fellowship may treat a patient for up to fifteen (15) consecutive business days without a referral.

The physical therapist must obtain a referral from a referring practitioner before the physical therapist continues treatment that exceeds treatment days authorized/

Patient disclosure

A physical therapist who treats a patient without a referral shall obtain from the patient a signed disclosure on a form prescribed by the board in which the patient acknowledges that:

    • Physical therapy is not a substitute for a medical diagnosis by a physician;
    • Physical therapy is not based on radiological imaging;
    • A physical therapist cannot diagnose an illness or disease; and
    • The patient's health insurance may not include coverage for the physical therapist's services.


In an emergency circumstance, including a minor emergency, a physical therapist may provide emergency medical care to a person to the best of the therapist's ability without a referral from a referring practitioner.

"Emergency medical care" means a bona fide emergency service provided after the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:

    • Serious jeopardy to the patient's health;
    • Serious dysfunction of any bodily organ or part; or
    • Serious impairment to bodily functions.

Additional Exemptions

A PT may evaluate without referral.

A PT may provide instructions to any person who is asymptomatic relating to the instructions being given without a referral, including instruction to promote health, wellness, and fitness.

Which providers can issue the referral?

The term includes:

    • A physician licensed to practice medicine by a state board of medical examiners;
    • A dentist licensed by a state board of dental examiners;
    • A chiropractor licensed by a state board of chiropractic examiners; and
    • A podiatrist licensed by a state board of podiatric medical examiners.

How may the referral by transmitted?

Referral may be transmitted by a qualifying referral source in the following ways:

    • In a written document, including faxed and emailed documents; or
    • Verbally, in person or by telephone. If a referral is transmitted verbally, whether in person or by telephone, it must be received, recorded and signed by the PT, PTA or other authorized personnel, and include all of the information that would appear on a written referral.


Tex. Occ. Code § 453.301

Tex. Occ. Code § 453.302

3 Tex. Admin. Code §322.1

Powered by Wild Apricot Membership Software