Practice Alerts

Disclaimer: Practice guidelines provide licensees with general guidance to promote good practice. Law, rules and regulations, not guidelines, specify the requirements for practice and what may constitute professional misconduct.

Alert 1: Referral for Physical Therapy Treatment

A physical therapist (PT) may treat a patient/client after receiving a referral from an authorized health care provider (physician, nurse practitioner, podiatrist, dentist or midwife) licensed and currently registered to practice in New York State. Education Law allows a physician licensed in a bordering state and who resides near the border of New York to practice in New York State without being licensed. This has been interpreted to allow a physician who lives within 25 miles of the New York State border to prescribe physical therapy treatment for a patient/client in New York. This exemption does not extend to any other professionals authorized to issue referrals for physical therapy.

A physician assistant (PA) may order physical therapy services, since the PA is acting as the agent of a licensed physician. However, it is important to know insurance company requirements regarding signatures, since some may not reimburse for treatment unless a physician or other licensed health care provider identified in law signs the referral.

A PT with the equivalent of three years of full-time experience practicing physical therapy may treat without a referral for 10 visits or 30 days, whichever comes first. A PT providing such treatment without referral must provide the patient/client with a written Notice of Advice, indicating that treatment without a referral may not be covered by the patient/client's health care plan or insurer but that it may be covered if provided pursuant to a valid referral. This Notice of Advice must be provided on a form, a copy of which must be kept on file by the licensed PT as a patient/client record and a copy of which must be given to the patient/client. The Notice of Advice must include the following information:

  • a statement of such advice and a statement attesting that the patient/client read the Notice of Advice;
  • the date treatment will begin;
  • the patient/client's name and address;
  • the patient/client's signature and date the patient/client signed the form;
  • the treating PT's name and address; and
  • the treating PT's signature and the date the PT signed the form.

Education Law is silent as to the length of time for which a referral is valid. For more on this issue, see Practice Alert 2.

Citations of Pertinent Law, Rules or Regulations:
Education Law, Section 6509 – definition of professional misconduct
Education Law, Section 6526(2) – exempt persons with respect to the practice of medicine
Education Law, Section 6731 – definition of physical therapy practice
Regulations of the Commissioner, Section 77.9 – providing treatment in the practice of physical therapy without referral
Last Updated: April 15, 2021