(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.
(3) Methods of referral. A referral may be transmitted by a qualifying referral source in the following ways:
(b) Evaluation and screening.
(1) Evaluation. Physical therapy treatment may not be provided prior to the completion of an evaluation of the patient's condition by a PT.
(2) PTAs may screen patients designated by a PT as possible candidates for physical therapy services. Screening entails the collection of uniform information from all patients screened using a predetermined, standardized format. The information collected is delivered to the supervising PT. Only a PT may determine whether further intervention for patients screened is necessary.
(c) Physical therapy plan of care development and implementation.
(1) The PT must develop a written plan of care, based on his evaluation, for each patient.
(2) Treatment may not be provided by a PTA or aide until the plan of care has been established.
(3) The plan of care must be reviewed and updated as necessary following a reevaluation of the patient's condition.
(4) The plan of care or treatment goals may only be changed or modified by a PT.
(5) A PTA may modify treatment techniques as indicated in the plan of care.
(6) A PT or PTA must interact with the patient regarding his/her condition, progress and/or achievement of goals during each treatment session.
(d) Reevaluation.
(1) Provision of physical therapy treatment by a PTA or an aide may not continue if the PT has not performed a reevaluation:
(2) A reevaluation must include:
(e) Documentation of treatment.
(1) At a minimum, documentation of physical therapy services must include the following:
(2) The PTA must include the name of the supervising PT in his documentation of each treatment session.
(3) Physical therapy aides may not write or sign any physical therapy documents in the permanent record. However, a physical therapy aide may enter quantitative data for tasks delegated by the supervising PT or PTA.
(4) Discharge Summary. The PT must provide final documentation for discharge of a patient, including patient response to treatment at the time of discharge and any necessary follow-up plan. A PTA may participate in the discharge summary by providing subjective and objective patient information to the supervising physical therapist.
Source Note: The provisions of this §322.1 adopted to be effective April 15, 1999, 24 TexReg 2935; amended to be effective November 19, 2001, 26 TexReg 9382; amended to be effective September 18, 2006, 31 TexReg 7998; amended to be effective February 18, 2008, 33 TexReg 1335; amended to be effective April 4, 2011, 36 TexReg 2124; amended to be effective March 1, 2015, 40 TexReg 704; amended to be effective September 4, 2016, 41 TexReg 6497; amended to be effective November 1, 2019, 44 TexReg 6369; amended to be effective November 1, 2021, 46 TexReg 7213