Updated: Dec 25, 2019
"Do I need a referral for physical therapy in Illinois?"
No, Illinois allows for direct access to physical therapy examination and treatment without referral.
The Illinois Physical Therapy Practice Act, Section 1.2, states: "A physical therapist may provide physical therapy services to a patient with or without a referral from a health care professional."
Some health insurance companies may still require a referral, and prospective patients interested in using their insurance benefits are advised to contact their company for confirmation before beginning physical therapy. Patients electing private pay do not need a referral.
Direct access to physical therapy in Illinois may shorten time before treatment, decrease patient expenses and health care utilization, and reduce the need for injections, medications, and surgeries.
For those interested in the specifics of direct access to physical therapy in Illinois, the unedited details from the Illinois Physical Therapy Practice Act are as follows:
Sec. 1.2. Physical therapy services. (a) A physical therapist may provide physical therapy services to a patient with or without a referral from a health care professional.
(b) A physical therapist providing services without a referral from a health care professional must notify the patient's treating health care professional within 5 business days after the patient's first visit that the patient is receiving physical therapy. This does not apply to physical therapy services related to fitness or wellness, unless the patient presents with an ailment or injury.
(c) A physical therapist shall refer a patient to the patient's treating health care professional of record or, in the case where there is no health care professional of record, to a health care professional of the patient's choice, if:
(1) the patient does not demonstrate measurable or functional improvement after 10 visits or 15 business days, whichever occurs first, and continued improvement thereafter;
(2) the patient returns for services for the same or similar condition after 30 calendar days of being discharged by the physical therapist; or
(3) the patient's condition, at the time of evaluation or services, is determined to be beyond the scope of practice of the physical therapist. (d) Wound debridement services may only be provided by a physical therapist with written authorization from a health care professional.
(e) A physical therapist shall promptly consult and collaborate with the appropriate health care professional anytime a patient's condition indicates that it may be related to temporomandibular disorder so that a diagnosis can be made by that health care professional for an appropriate treatment plan.
I hope you have found this information on direct access to physical therapy in Illinois valuable. For more information, you are also invited to consider some helpful tips on how to choose a physical therapist, learn about orthopedic manual physical therapy, and consider the science behind how pain works or how orthopedic manual physical therapy works.
Dr. Damon Bescia is a fellowship-trained Doctor of Physical Therapy, board certified in orthopedics and sports physical therapy, who specializes in Orthopedic Manual Physical Therapy and serves Naperville and its surrounding communities by way of his Concierge Practice by providing private one-to-one physical therapy. For more information, please visit https://www.napervillemanualphysicaltherapy.com.