Physical Therapy Direct Access Statement

Physical Therapy Direct Access1:

Currently, 50 states and the District of Columbia (DC) allow physical therapists to evaluate patients without a prior physician's referral and 48 states, including Iowa, improve accessibility further by allowing physical therapists to evaluate and treat patients without a referral from a physician.

Benefits of Direct Access2:

  • Patients who visited a physical therapist directly for outpatient care had fewer visits and lower overall costs on average than those who were referred by a physician.
  • Health care use did not increase for patients directly accessing physical therapy services, nor was continuity of care hindered.
  • Patients seen via direct access were still in contact with physicians during and after physical therapy.

Communication with Your Physician

  • Physical therapists will refer a patient to a physician if their condition is determined to be in need of a physician's evaluation.
  • Patients should continue regular care and communication with their primary care physician.


Most insurance companies cover direct access visits to physical therapists. Medicare recipients are required to have a physician authorize physical therapy care. Patients utilizing worker's compensation require a physician referral. Contact your medical insurance company to find out if they pay for physical therapy without a physician referral.


  1.; Last Updated: 5/16/2014; Contact: American Physical Therapy Association
  2. Pendergast J, Kliethermes SA, Freburger JK, Duffy PA. A comparison of health care use for physician-referred and self-referred episodes of outpatient physical therapy. Health Services Research. Published ahead of print September 23, 2011. DOI: 10.1111/j.1475-6773.2011.01324.