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Physical Therapist "Open Access"

March 24, 2003 | Legal Alert
Markley Roderick
A New Jersey statute recently signed into law by Governor McGreevey gives physical therapists the right to evaluate and treat patients without referral from a physician. This statute, breaking with prior New Jersey law, may have significant implications for the future.

Under prior law, a physical therapist could evaluate a patient, but was not permitted to begin treatment without a physician referral. Traditionally the referral to a physical therapist would come from a plenary-licensed physician, i.e., an MD or DO. Within the last several years, regulations were issued permitting chiropractors to refer patients to physical therapists for treatment of spine-related problems.

The new law gives physical therapists broad rights to evaluate and treat patients without any referral whatsoever. New Jersey thus joins a large majority of other states in permitting "open access" to physical therapists.

The new law is subject to several important qualifications, including the following:

Three other important limitations will restrict the concept of complete open access. One, a referral is still required if the physical therapy services are to be reimbursed under the PIP program. Two, the New Jersey law has no effect on reimbursement under the Medicare program. Three, many private insurance policies that is, major medical policies require such a referral as a condition of reimbursement. It is not clear whether these policies will be changed as a result of the new law.

Of course, the foregoing is merely a summary of the new statute, and should not be relied upon as legal advice in a specific situation. If you would like a copy of the statute, or would like to discuss how it may apply to your own practice, please let us know.   

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