March 2022 Texas Board of Physical Therapy Examiners
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(15) Physical therapy--The evaluation, examination, and utilization of exercises, rehabilitative
procedures, massage, manipulations, and physical agents including, but not limited to, mechanical
devices, heat, cold, air, light, water, electricity, and sound in the aid of diagnosis or treatment. Physical
therapists may perform evaluations without referrals. Physical therapy practice includes the use of
modalities, procedures, and tests to make evaluations. Physical therapy practice includes, but is not
limited to the use of: Electromyographic (EMG) Tests, Nerve Conduction Velocity (NCV) Tests,
Thermography, Transcutaneous Electrical Nerve Stimulation (TENS), bed traction, application of topical
medication to open wounds, sharp debridement, provision of soft goods, inhibitive casting and splinting,
Phonophoresis, Iontophoresis, and biofeedback services.
(16) Supervision--The delegation and continuing direction by a person or persons responsible for the
practice of physical therapist, physical therapist assistant, or physical therapy aide as specified in the
Physical Therapy Practice Act.
Source Note: The provisions of this §321.1 adopted to be effective March 1, 1986, 11 TexReg 719; amended to be effective September 28,
1988, 13 TexReg 4575; amended to be effective December 12, 1989, 14 TexReg 6277; amended to be effective January 7, 1992, 16 TexReg
7644; amended to be effective January 12, 1993, 18 TexReg 63; amended to be effective November 11, 1993, 18 TexReg 7545; amended to
be effective November 6, 1995, 20 TexReg 8793; amended to be effective May 8, 1996, 21 TexReg 3794; amended to be effective July 9,
1996, 21 TexReg 6078; amended to be effective April 28, 1997, 22 TexReg 3588; amended to be effective October 6, 1998, 23 TexReg 9978;
amended to be effective April 15, 1999, 24TexReg 2935; amended to be effective May 14, 2000, 25 TexReg 4351; amended to be effective
November 16, 2000, 25 TexReg 11285; amended to be effective August 15, 2001, 26 TexReg 6020; amended to be effective September 18,
2006, 31 TexReg 7997; amended to be effective February 13, 2012, 37 TexReg 689.
CHAPTER 322. PRACTICE
§322.1. Provision of Services.
(a) Initiation of physical therapy services.
(1) Referral requirement. Except as authorized by paragraph (2) of this subsection, a physical
therapist is subject to discipline from the board for providing physical therapy treatment without
a referral from a qualified healthcare practitioner licensed by the appropriate licensing board,
who within the scope of the professional licensure is authorized to prescribe treatment of
individuals. The list of qualifying referral sources includes physicians, dentists, chiropractors,
podiatrists, physician assistants, and advanced nurse practitioners.
(2) Exceptions to referral requirement.
(A) A PT may evaluate without referral.
(B) A PT may provide instructions to any person who is asymptomatic relating to the
instructions being given without a referral, including instruction to promote health,
wellness, and fitness.
(C) Emergency Circumstances. A PT may provide emergency medical care to a person
after the sudden onset of a medical condition manifesting itself by acute symptoms of
sufficient severity without referral if the absence of immediate medical attention could
reasonably be expected to result in a serious threat to the patient's health, serious
impairment to bodily functions, or serious dysfunction of any bodily organ or part.
(D) A PT may treat a patient for an injury or condition without a referral for not more than
10 consecutive business days if the PT:
(i) has been licensed to practice physical therapy for at least one year;
(ii) is covered by professional liability insurance in the minimum amount of
$100,000 per claim and $300,000 aggregate per year; and
(iii) either: