54.1-3482 - Certain experience and referrals required; unlawful to practice physical therapist assistance except under the direction and control of a licensed physical therapist.
§ 54.1-3482. Certain experience and referrals required; unlawful to practicephysical therapist assistance except under the direction and control of alicensed physical therapist.
A. It shall be unlawful for a person to engage in the practice of physicaltherapy except as a licensed physical therapist, upon the referral anddirection of a licensed doctor of medicine, osteopathy, chiropractic,podiatry, dental surgery, licensed nurse practitioner as authorized in hispractice protocol, or a licensed physician assistant acting under thesupervision of a licensed physician, except as provided in this section.
B. A physical therapist who has obtained a certificate of authorizationpursuant to § 54.1-3482.1 may evaluate and treat a patient for no more than14 consecutive business days after evaluation without a referral under thefollowing conditions: (i) the patient at the time of presentation to aphysical therapist for physical therapy services is not being currently caredfor, as attested to in writing by the patient, by a licensed doctor ofmedicine, osteopathy, chiropractic, podiatry, dental surgery, licensed nursepractitioner as authorized in his practice protocol, or a licensed physicianassistant acting under the supervision of a licensed physician for thesymptoms giving rise to the presentation; (ii) the patient identifies apractitioner from whom the patient intends to seek treatment if the conditionfor which he is seeking treatment does not improve after evaluation andtreatment by the physical therapist during the 14-day period of treatment;(iii) the patient gives written consent for the physical therapist to releaseall personal health information and treatment records to the identifiedpractitioner; and (iv) the physical therapist notifies the practitioneridentified by the patient no later than three days after treatment commencesand provides the practitioner with a copy of the initial evaluation alongwith a copy of the patient history obtained by the physical therapist.Evaluation and treatment may not be initiated by a physical therapist if thepatient does not identify a licensed doctor of medicine, osteopathy,chiropractic, podiatry, dental surgery, licensed nurse practitioner asauthorized in his practice protocol, or a licensed physician assistant actingunder the supervision of a licensed physician to manage the patient'scondition. Treatment for more than 14 consecutive business days afterevaluation of such patient shall only be upon the referral and direction of alicensed doctor of medicine, osteopathy, chiropractic, podiatry, dentalsurgery, licensed nurse practitioner as authorized in his practice protocol,or a licensed physician assistant acting under the supervision of a licensedphysician. A physical therapist may contact the practitioner identified bythe patient at the end of the 14-day period to determine if the practitionerwill authorize additional physical therapy services until such time as thepatient can be seen by the practitioner. A physical therapist shall notperform an initial evaluation of a patient under this subsection if thephysical therapist has performed an initial evaluation of the patient underthis subsection within the immediately preceding three months. For thepurposes of this subsection, business days means Monday through Friday ofeach week excluding state holidays.
C. After completing a three-year period of active practice upon the referraland direction of a licensed doctor of medicine, osteopathy, chiropractic,podiatry, dental surgery, licensed nurse practitioner as authorized in hispractice protocol, or a licensed physician assistant acting under thesupervision of a licensed physician, a physical therapist may conduct aone-time evaluation, that does not include treatment, of a patient who doesnot meet the conditions established in (i) through (iv) of subsection Bwithout the referral and direction of a licensed doctor of medicine,osteopathy, chiropractic, podiatry, dental surgery, licensed nursepractitioner as authorized in his practice protocol, or a licensed physicianassistant acting under the supervision of a licensed physician; ifappropriate, the physical therapist shall immediately refer such patient tothe appropriate practitioner.
D. Invasive procedures within the scope of practice of physical therapy shallat all times be performed only under the referral and direction of a licenseddoctor of medicine, osteopathy, chiropractic, podiatry, dental surgery,licensed nurse practitioner as authorized in his practice protocol, or alicensed physician assistant acting under the supervision of a licensedphysician.
E. It shall be unlawful for any licensed physical therapist to fail toimmediately refer any patient to a licensed doctor of medicine, osteopathy,chiropractic, podiatry, or dental surgery, or a licensed nurse practitioneras authorized in his practice protocol, whose medical condition isdetermined, at the time of evaluation or treatment, to be beyond the physicaltherapist's scope of practice. Upon determining that the patient's medicalcondition is beyond the scope of practice of a physical therapist, a physicaltherapist shall immediately refer such patient to an appropriate practitioner.
F. Any person licensed as a physical therapist assistant shall perform hisduties only under the direction and control of a licensed physical therapist.
G. However, a licensed physical therapist may provide, without referral orsupervision, physical therapy services to (i) a student athlete participatingin a school-sponsored athletic activity while such student is at suchactivity in a public, private, or religious elementary, middle or highschool, or public or private institution of higher education when suchservices are rendered by a licensed physical therapist who is certified as anathletic trainer by the National Athletic Trainers' Association Board ofCertification or as a sports certified specialist by the American Board ofPhysical Therapy Specialties; (ii) employees solely for the purpose ofevaluation and consultation related to workplace ergonomics; (iii) specialeducation students who, by virtue of their individualized education plans(IEPs), need physical therapy services to fulfill the provisions of theirIEPs; (iv) the public for the purpose of wellness, fitness, and healthscreenings; (v) the public for the purpose of health promotion and education;and (vi) the public for the purpose of prevention of impairments, functionallimitations, and disabilities.
(2000, c. 688; 2001, c. 858; 2002, cc. 434, 471; 2003, c. 496; 2005, c. 928;2007, cc. 9, 18.)