OAR 848-040-0117: Standards For Authorization To Provide Physical Therapy Services

As a result of legislative changes effective January 1, 2014, a physical therapist is no longer required to limit treatment of a self-referred patient to 60 days before having to refer the patient to a provider identified in ORS 688.132(1). (1) A physical therapist may initiate and provide physical therapy to a patient who is either self-referred or referred by a “provider of care”, defined in ORS 688.132 as a medical doctor, osteopathic physician, chiropractic physician, podiatric physician and surgeon, naturopathic physician, dentist, physician assistant or nurse practitioner, as follows: (a) The therapist shall treat a self-referred patient in accordance with an initial evaluation and treatment plan prepared by a physical therapist and shall treat a patient who is referred by a provider of care pursuant to the written or oral referral or authorization received from the provider. As used in this rule, the term “authorization” includes certification by a provider of care of the physical therapist’s plan of care of a Medicare patient. (b) If the referral or authorization specifies or identifies specific physical therapy interventions, precautions or contraindications for therapy, physical therapy shall not be provided beyond those specifications or limitations without further authorization. (c) If a patient who is being treated pursuant to a referral or authorization from a provider of care requests treatment for a diagnosis or condition that is different and separate from the diagnosis or condition that is the subject of the referral, the physical therapist may initiate and provide treatment either in accordance with an initial evaluation and treatment plan prepared by a physical therapist or pursuant to an additional written or oral referral or authorization received from a provider listed in this section. (d) If a referral or authorization specifies the number of treatments or a duration of treatment, the physical therapist may treat the patient for that duration and may extend treatment for a reasonable period of time if necessary for the patient to receive all authorized treatments. (e) A physical therapist shall immediately refer a patient to a provider of care if the patient exhibits symptoms: (A) That require treatment or diagnosis by a provider of medical care; (B) For which physical therapy is contraindicated; (C) For which the treatment is outside that therapist’s knowledge, skill and abilities; or (D) For which treatment is outside the scope of practice of physical therapy. (2) A physical therapist may provide physical therapy treatment to an animal under a referral from a veterinarian licensed under ORS Chapter 686. The referral must be in writing and specify the treatment or therapy to be provided pursuant to 686.040(4). The standard of care and documentation for physical therapy care to an animal shall be as provided for veterinarians under ORS Chapter 686. (3) Notwithstanding the provisions of this rule, and pursuant to ORS 656.250, a physical therapist shall not provide compensable services to an injured worker governed by ORS Chapter 656 except as allowed by a governing managed care organization contract or as authorized by the worker's attending physician.