Virginia is one of 26 states that allow direct patient access to PT with some provisions. A physical therapist who has obtained a doctorate of physical therapy or a certificate of authorization pursuant to Section 54.1-3482.1 may evaluate and treat a patient with direct access for physical therapy in Virginia for no more than 30 consecutive days after an initial evaluation under the following conditions:

The patient is not receiving care from a licensed healthcare provider, a nurse practitioner acting in accordance with his or her practice agreement, or licensed physician assistant under supervision of a physician for the symptoms that prompted the patient to seek direct access physical therapy services in Virginia;

The patient identifies a licensed healthcare provider, a licensed nurse practitioner practicing in accordance with his or her practice agreement, or a licensed physician assistant under the supervision of a physician from whom the patient is currently receiving care;

The patient provides written consent for the physical therapist in Virginia to release all personal health information (PHI) and treatment records to the identified provider; and

The physical therapist notifies the specified provider within 14 days after the initial direct access physical treatment in Virginia and provides the provider with a copy of the initial evaluation along with a copy of the patient history.

The PT shall not treat the patient for more than 30 consecutive days after evaluation without the referral of a licensed healthcare provider, nurse practitioner (in accordance with his or her practice agreement), or physician assistant acting under a licensed physician.

The physical therapist may contact the identified provider at the end of the 30-day period to obtain authorization of additional direct access physical therapy services in Virginia until the patient can be seen by the provider.

A PT cannot perform an initial evaluation of the patient if the PT has performed an initial evaluation of the patient for the same condition within the past 60 days.

A physical therapist who has not obtained a doctorate of physical therapy or certificate of authorization pursuant to Section 54.1-3482.1 can conduct a one-time evaluation of a patient. However, the therapist cannot provide physical therapy treatment in Virginia without a referral.

The PT must immediately refer the patient to an appropriate provider if necessary.

Note that a PT can provide direct access to physical therapy in Virginia with no restrictions under the following circumstances:

To student athletes in a school setting;

For workplace ergonomics;

To special education students;

For wellness, fitness, and health screenings; and

For preventive services.

Invasive procedures within the scope of PT practice may only be performed under the referral or direction of an appropriate healthcare provider, nurse practitioner, or physician assistant under the direction of a licensed physician.