Direct Access In Illinois
Governor signs new law to facilitate access to physical therapy services
SPRINGFIELD — Gov. Bruce Rauner today signed House Bill 4643, which allows consumers to pursue and begin physical therapy services without a doctor’s referral while still ensuring professional medical oversight safeguards.
The law, effective immediately, permits physical therapists to evaluate clients and determine a treatment plan without first having to submit a diagnosis for a health care professional’s approval, speeding the path to relief and healing.
“Physical therapy has been proven effective in treating joint pain and mobility issues,” Rauner said. “Seeing a physical therapist promptly and starting a rehabilitative course of treatment quickly can reduce or eliminate the need for potentially addicting pain medications, and can reduce overall health care costs. This legislation is a win for everyone.”
Under the legislation, a physical therapist providing services without a referral from a health care professional must notify the patient’s treating health care professional within five business days that the patient is receiving physical therapy. This does not apply to those seeking physical therapy for general, non-injury-related fitness or wellness.
“Studies across the country have shown that direct access to physical therapy is extremely cost-effective, reducing total health care costs by as much as 30 percent and, in some cases, reducing patients’ out-of-pocket costs by as much as 80 percent,” said Mike Riley, president, Illinois Physical Therapy Association.
“The most important benefit, however, is that studies have shown an amazing 90 percent reduction in opioid use when consumers have access to physical therapy,” he continued. “Since physical therapy is a non-addictive treatment that helps manage pain, thousands of Illinois pain sufferers will get relief without opioids. The health and cost benefits of this alone are staggering.”
“This bill was a result of collaboration within Illinois’ health care community on behalf of patients in Illinois,” said Colleen Flannery, executive director of the Illinois Physical Therapy Association. “We thank Gov. Rauner for making it a priority today, and we are grateful for the unanimous, bipartisan support of the General Assembly.”
*This information is provided by IPTA (Illinois Physical Therapy Association) visit their website to learn more
How does this affect your access to Physical Therapy?
While before you needed a prescription or a referral from a doctor, you can now visit a physical therapist without that - whether for an injury, a sore muscle or pain, to improve your fitness and mobility or to address a functional goal, among other reasons.
Important things to know.....
Your physical therapist must notify your primary health care professional within 5 business days of when you visit them and receive physical therapy treatment
Your physical therapist will need to refer you to a health care professional if....
There is no measurable functional improvement after 10 visits or 15 business days, whichever occurs first
You are returning to physical therapy for the same or similar condition after 30 calendar days of being discharged by your physical therapist
Your condition is determined to need more than physical therapy during your initial evaluation
While the new law makes it easier to access physical therapy, not every health plan is required to cover physical therapy. It is recommended that you contact your insurance provider before visiting a physical therapist to ensure the visit will be covered by your insurance plan.