Direct Access

Direct access refers to patients' ability to directly seek healthcare services from a licensed healthcare provider without first obtaining a referral or prescription from another healthcare professional.

In the context of physical therapy, direct access allows patients to seek evaluation, diagnosis, and treatment for musculoskeletal conditions, injuries, and disabilities directly from a licensed physical therapist without a referral from a physician or other healthcare provider.

The passing of the Illinois Physical Therapy Practice Act in 2018 granted Illinois residents direct access to physical therapy from state-licensed physical therapists.

Direct access can offer several benefits to patients, including increased convenience, faster access to care, and potentially lower healthcare costs. However, not all insurance plans may cover direct access physical therapy services. Be sure to check with your insurance provider to understand your coverage and any potential out-of-pocket costs.

More commonly, you may be able to access physical therapy without a referral, depending on your location, your insurance, and the specific rules and regulations governing healthcare in your area. This is known as direct access.

However, a physician referral or prescription may still be required for physical therapy, particularly if you seek treatment for a specific medical condition or injury. This is because physical therapists work closely with physicians and other healthcare providers to develop treatment plans that are tailored to your individual needs and medical history.

The length of time that you can see a physical therapist before needing to see a physician will depend on several factors, including the specific laws and regulations governing healthcare in your state, the nature and severity of your condition, and your individual treatment plan.

In Illinois, you can seek treatment without a referral for 10 visits or 15 business days, whichever comes first. If your condition does not improve within that time period, your physical therapist is required to refer you to a healthcare specialist.

However, if your condition is more complex or if your physical therapist believes that you condition may require additional medical intervention, they may recommend that you see a physician for further evaluation and treatment. Additionally, if you experience new or worsening symptoms during the course of your physical therapy treatment, it's important to consult with a physician to rule out any underlying medical issues.

Ultimately, deciding when to involve a physician in your care will depend on the specifics of your condition and treatment plan. This decision should be made in consultation with your physical therapist and other healthcare providers as appropriate.