334.506. Physical therapists may provide certain services without prescription or direction of an approved health care provider, when--limitations.

Physical therapists may provide certain services without prescriptionor direction of an approved health care provider,when--limitations.

334.506. 1. As used in this section, "approved health care provider"means a person holding a current and active license as a physician andsurgeon under this chapter, a chiropractor under chapter 331, RSMo, adentist under chapter 332, RSMo, a podiatrist under chapter 330, RSMo, aphysician assistant under this chapter, or any licensed and registeredphysician, chiropractor, dentist, or podiatrist practicing in anotherjurisdiction whose license is in good standing.

2. A physical therapist shall not initiate treatment for a new injuryor illness without a prescription from an approved health care provider.

3. A physical therapist may provide educational resources andtraining, develop fitness or wellness programs for asymptomatic persons, orprovide screening or consultative services within the scope of physicaltherapy practice without the prescription and direction of an approvedhealth care provider.

4. A physical therapist may examine and treat without theprescription and direction of an approved health care provider any personwith a recurring self-limited injury within one year of diagnosis by anapproved health care provider or a chronic illness that has been previouslydiagnosed by an approved health care provider. The physical therapistshall:

(1) Contact the patient's current approved health care providerwithin seven days of initiating physical therapy services under thissubsection;

(2) Not change an existing physical therapy referral available to thephysical therapist without approval of the patient's current approvedhealth care provider;

(3) Refer to an approved health care provider any patient whosemedical condition at the time of examination or treatment is determined tobe beyond the scope of practice of physical therapy;

(4) Refer to an approved health care provider any patient whosecondition for which physical therapy services are rendered under thissubsection has not been documented to be progressing toward documentedtreatment goals after six visits or fourteen days, whichever first occurs;

(5) Notify the patient's current approved health care provider priorto the continuation of treatment if treatment rendered under thissubsection is to continue beyond thirty days. The physical therapist shallprovide such notification for each successive period of thirty days.

5. The provision of physical therapy services of evaluation andscreening pursuant to this section shall be limited to a physicaltherapist, and any authority for evaluation and screening granted withinthis section may not be delegated. Upon each reinitiation of physicaltherapy services, a physical therapist shall provide a full physicaltherapy evaluation prior to the reinitiation of physical therapy treatment.Physical therapy treatment provided pursuant to the provisions ofsubsection 4 of this section may be delegated by physical therapists tophysical therapist assistants only if the patient's current approved healthcare provider has been so informed as part of the physical therapist'sseven-day notification upon reinitiation of physical therapy services asrequired in subsection 4 of this section. Nothing in this subsection shallbe construed as to limit the ability of physical therapists or physicaltherapist assistants to provide physical therapy services in accordancewith the provisions of this chapter, and upon the referral of an approvedhealth care provider. Nothing in this subsection shall prohibit anapproved health care provider from acting within the scope of theirpractice as defined by the applicable chapters of RSMo.

6. No person licensed to practice, or applicant for licensure, as aphysical therapist or physical therapist assistant shall make a medicaldiagnosis.

7. A physical therapist shall only delegate physical therapytreatment to a physical therapist assistant or to a person in an entrylevel of a professional education program approved by the Commission forAccreditation of Physical Therapists and Physical Therapist AssistantEducation (CAPTE) who satisfies* supervised clinical education requirementsrelated to the person's physical therapist or physical therapist assistanteducation. The entry-level person shall be under on-site supervision of aphysical therapist.

(L. 1999 H.B. 343 merged with S.B. 8 & 173, A.L. 2004 S.B. 1122 merged with S.B. 1181, A.L. 2008 S.B. 788)

*Word "satisfy" appears in original rolls.