Section 34-24-210.1 - Evaluation and treatment by physical therapist(a) A physical therapist may not treat patients without a referral from a physical therapy referrer unless the physical therapist possesses a doctorate in physical therapy or a master's degree from an accredited institution along with 10 years of clinical practice experience and is licensed as a physical therapist in this state having passed the examination of the Federation of State Boards of Physical Therapy.(b) In addition to the requirements of Section 34-24-216, a physical therapist shall annually complete an additional two hours of continuing education focusing on the professional standard of care.(c) In treating a patient, the physical therapist shall exercise the reasonable care, skill, and diligence as other similarly situated health care providers in the same general line of practice ordinarily have and exercise in a like case.(d)(1) Except as otherwise provided in this section, and except with respect to patients seeking treatment for work-related injuries, infirmities, diseases, or conditions which do not provide any basis for establishing a claim or right to recover under Alabama's Workers Compensation Act, Section 25-5-1 et seq., a physical therapist meeting the educational requirements of subsection (a), without a referral, may perform an initial screening evaluation or consultation for patients with non-work related injuries, infirmities, diseases, or conditions to determine the need for physical therapy, establish a plan of care, and initiate physical therapy services without a referral. An individual seeking treatment for physical therapy services who is paying cash shall have direct access without restriction.(2) A physical therapist meeting the educational requirements of subsection (a) may perform physical therapy on a patient without a referral from a physical therapy referrer. If the patient does not have a beneficial response to the physical therapy in 30 calendar days, or 11 visits, whichever occurs first, the patient shall be referred to a health care provider as appropriate. These treatment limitations shall not apply to any of the following:a. A child with a diagnosed developmental disability pursuant to the plan of care for the child developed by a physical therapy referrer.b. A patient of a home health agency pursuant to the agency's plan of care for the patient.c. A patient of a nursing home pursuant to the plan of care for the patient developed by the medical staff of the nursing home.d. A patient previously diagnosed with a chronic condition for which physical therapy services are appropriate after informing the physical therapy referrer rendering the diagnosis. The diagnosis shall have been made within the immediately preceding 120 days. The physical therapist shall provide the physical therapy referrer with a plan of care for physical therapy services within the first 15 days of treatment.e. Education or activities in a wellness setting relating to conditioning for the purpose of prevention of injury, reduction of stress, or promotion of fitness.(e) The licensed physical therapist shall immediately refer a patient to other health care providers upon a measurable deterioration in the patient's condition.(f) A physical therapist treating a patient referenced in subdivision (d)(2) without a referral from a physical therapy referrer, prior to beginning treatment, shall provide written disclosure to the patient that the physical therapist's assessment is not a medical diagnosis and is not based on any radiologic or medical imaging.(g) Failure of a physical therapist to timely refer the patient to a physical therapy referrer when the patient exhibits or develops signs, symptoms, or conditions requiring treatment beyond the scope of practice of physical therapy shall constitute unprofessional conduct under the rules of the board.(h) A physical therapist is prohibited from doing any of the following:(1) Practicing medicine, osteopathy, dentistry, or chiropractic medicine.(2) Ordering or interpreting any form of radiologic or medical imaging.(3) Ordering or interpreting any diagnostic testing, including clinical laboratory tests.(4) Ordering any type of medical procedure.(5) Ordering, prescribing, or administering any prescription medication or drug; however, a physical therapist may administer topical medications for which a prescription is not required or for which the patient has a valid order or prescription.(6) Admitting or discharging a patient from any health care facility licensed in this state.(7) Performing physical therapy on any individual who suffered a concussion within the previous 45 days, unless cleared for physical therapy by a physician licensed to practice medicine or osteopathy.(8) Performing sports physicals on or certifying a student athlete as capable of returning to play; however, a physical therapist may assist in sports physicals performed by licensed physicians or in assessing the extent of movement dysfunctions for student athletes to return to play when no other conditions exist.(9) Performing physical therapy on any individual who has undergone a surgical procedure for a diagnosed condition within the previous 90 days without a referral from a physical therapy referrer. This would not prevent an individual from seeking treatment for any other treatment unrelated to the surgical procedure.(10) Directing or supervising more than four physical therapy assistants at one time.(i) No physical therapy referrer shall be civilly liable for any act, omission, advice, care, or service provided by a physical therapist or other individual providing physical therapy services without a referral.(j) For any physical therapist treating a patient without a referral from a physical therapy referrer, the physical therapist shall maintain professional liability insurance at a limit of no less than one hundred thousand dollars ($100,000) per occurrence and three hundred thousand dollars ($300,000) aggregate. The board may adopt rules to increase, but may not decrease, the minimum professional liability insurance carried by a physical therapist treating a patient without a referral from a physical therapy referrer.(k) A physical therapist possessing a doctoral degree may not utilize the terms "doctor" in any advertisements, representations, or statements made to the public related to the provision of physical therapy unless immediately followed by "Doctor of Physical Therapy", "DPT", or "PT" in the same size type and font.(l) Nothing in this act shall permit a licensed athletic trainer employed by a physical therapist to operate outside of his or her respective scope of practice, or in conflict with the Alabama Athletic Trainers Licensure Act, including requirements to work under the direction of a licensed physician. A physical therapist may not require a licensed athletic trainer, who is employed by the physical therapist to provide athletic training services, to refer patients to the clinic or facility where the physical therapist is employed.(m) Nothing contained in this act shall be construed to create a requirement that any health benefit plan, group insurance plan, policy, or contract for health care services that covers hospital, medical, or surgical expenses, health maintenance organizations, preferred provider organizations, medical service organizations, physician-hospital organizations, or any person, firm, corporation, joint venture, or other similar business entity that pays for, purchases, or furnishes group health care services to patients, insureds, or beneficiaries in this state, including entities created pursuant to Article 6, of Chapter 20, Title 10A, commencing with Section 10A-20-6.01, provide coverage or reimbursement for the services described or authorized in this act.Ala. Code § 34-24-210.1 (1975)
Amended by Act 2024-385,§ 2, eff. 6/1/2024.Amended by Act 2023-480,§ 1, eff. 9/1/2023.Added by Act 2012-260,§ 2, eff. 7/1/2012.