Section 1309 - Practice of physical therapy(a) Except as provided in subsection (b), no individual licensed under this act as a physical therapist shall treat human ailments by physical therapy or otherwise except by the referral of an individual licensed as a physician, a licensed physician assistant practicing pursuant to a written agreement with a physician or a certified registered nurse practitioner practicing pursuant to a collaborative agreement with a physician; however, a physical therapist shall be permitted to accept the referral of a licensed dentist or podiatrist, for the treatment of a condition that is within the scope of practice of dentistry or podiatry. Nothing in this act shall be construed as authorization for a physical therapist to practice any branch of the healing arts except as described in this act. For purposes of this section, relating to referrals, a licensed physician, dentist or podiatrist means an individual holding an active license in this Commonwealth, the District of Columbia or any other state or United States territory.(b) Licensees who meet the standards set forth in this subsection may apply to the board for a certificate of authorization to practice physical therapy under this act without the required referral under subsection (a). A certificate of authorization to practice physical therapy without a referral under subsection (a) shall not authorize a physical therapist either to treat a condition in an individual which is a nonneurologic, nonmuscular or nonskeletal condition or to treat an individual who has an acute cardiac or acute pulmonary condition unless the physical therapist has consulted with the individual's licensed physician, dentist or podiatrist regarding the individual's condition and the physical therapy treatment plan or has referred the individual to a licensed physician, dentist or podiatrist for diagnosis and referral. The certificate of authorization shall be issued only to licensed physical therapists practicing physical therapy. The certificate of authorization shall be displayed by the certificate holder in a manner conspicuous to the public. The renewal of the certificate of authorization shall coincide with the renewal of the license of the licensee. Licensees making application for a certificate of authorization shall present satisfactory evidence to the board of all of the following: (1) That the licensee has: (i) passed an examination for licensure to practice physical therapy, which examination included testing on the appropriate evaluative procedures to treat an individual without a referral; or(ii) passed an examination for licensure to practice physical therapy prior to 1990 and successfully completed a course approved by the board on the appropriate evaluative procedures to treat an individual without a referral.(2) That the licensee has: (i) practiced physical therapy as a licensed physical therapist in the delivery of patient care in accordance with this act on a continuous basis for at least two years immediately preceding the application for a certificate of authorization;(ii) been licensed under section 6(d.1) and has practiced physical therapy in the delivery of patient care as a licensed physical therapist in a reciprocal state on a continuous basis for at least two years immediately preceding the application for a certificate of authorization; or(iii) provided proof of meeting the standards of clause (i) or (ii) of this paragraph through the application of any combination thereof.(3) That the license of that licensee has been maintained in good standing.(4) That the licensee has professional liability insurance in accordance with the following provisions: (i) Deleted by 2008, July 4, P.L. 293, No. 38, § 8, effective in 90 days [Oct. 2, 2008].(ii) A licensee shall notify the board within 30 days of the licensee's failure to be covered by the required insurance. Failure to notify the board shall be actionable under section 11 or 12. Further, the certificate of authorization of that licensee shall automatically be suspended upon failure to be covered by the required insurance and shall not be restored until submission to the board of satisfactory evidence that the licensee has the required professional liability insurance coverage.(iii) The board shall accept from licensees as satisfactory evidence of insurance coverage under this subsection any or all of the following: self-insurance, personally purchased professional liability insurance, professional liability insurance coverage provided by the licensee's employer or any similar type of coverage.(iii.1) A licensee under this act, practicing in this Commonwealth, shall maintain a level of professional liability insurance coverage in the minimum amount of $1,000,000 per occurrence or claims made. Failure to maintain insurance coverage as required shall subject the licensee to disciplinary proceedings. The board shall accept as satisfactory evidence of insurance coverage any of the following: (B) personally purchased liability insurance; or(C) professional liability insurance coverage provided by the physical therapist's employer or similar insurance coverage acceptable to the board.(iii.2) A license applicant shall provide proof that the applicant has obtained professional liability insurance in accordance with subparagraph (iii.1). It is sufficient if the applicant files with the application a copy of a letter from the applicant's professional liability insurance carrier indicating that the applicant will be covered against professional liability in the required amounts effective upon the issuance of the applicant's license to practice physical therapy in this Commonwealth.(iii.3) Upon issuance of a license, a licensee has 30 days to submit to the board the certificate of insurance or a copy of the policy declaration page.(iv) The board shall adopt, by regulation, standards and procedures established by the Insurance Commissioner for self-insurance. In the absence of these standards and procedures, the board, after consultation with the Insurance Commissioner, shall establish standards and procedures by regulation for self-insurance under this subsection.(c)(1) For each renewal of the certificate of authorization, the licensee shall complete within the immediately preceding two-year period at least 30 hours of continuing physical therapy education related to keeping the certificate holder apprised of advancements and new developments in the practice of the physical therapy profession. At least ten of the 30 hours shall be in appropriate evaluative procedures to treat an individual without a referral. No credit shall be given for any course in office management or practice building. The licensee shall provide the board with evidence of the completion of the continuing education.(2) Continuing education programs and program providers under this subsection shall be approved by the board in accordance with standards and criteria established by the board by regulation. The regulation shall include any fees necessary to implement this provision and provide for waiver of the continuing education requirement due to illness or hardship in any licensing renewal period.(d) A physical therapist practicing physical therapy under this act shall refer patients to a licensed physician or other appropriate health care practitioner in any of the following cases:(1) Cases where symptoms are present for which physical therapy is a contraindication.(2) Cases for which treatment is outside the scope of practice of physical therapy.(3) Cases for which treatment is beyond the education, expertise or experience of the physical therapist.(e) A physical therapist may treat an individual without a referral as provided for in subsection (b) for up to 30 days from the date of the first treatment. A physical therapist shall not treat an individual beyond 30 days from the date of the first treatment unless he or she has obtained a referral from a licensed physician; a licensed physician assistant practicing pursuant to a written agreement with a physician; a certified registered nurse practitioner practicing pursuant to a collaborative agreement with a physician; or a licensed dentist or licensed podiatrist, for the treatment of a condition that is within the scope of practice of dentistry or podiatry. The date of the first treatment for purposes of this subsection is the date the individual is treated by any physical therapist treating without a referral.(f) Nothing in this section shall be construed to require or preclude third-party insurance reimbursement. Nothing herein shall preclude an insurer or other third-party payor from requiring that a physical therapist obtain a referral from a licensed physician; a licensed physician assistant practicing pursuant to a written agreement with a physician; a certified registered nurse practitioner practicing pursuant to a collaborative agreement with a physician; or a licensed dentist or licensed podiatrist, for the treatment of a condition that is within the scope of practice of dentistry or podiatry; or that a physical therapist file an evaluation and treatment plan with the insurer or third-party payor as a precondition of reimbursement.1975, Oct. 10, P.L. 383, No. 110, §9. Amended 1984 , April 4, P.L. 196, No. 41, § 5, effective 7/4/1984; 2002, Feb. 21, P.L. 90, No. 6, §2, effective in 60 days; 2008, July 4, P.L. 293, No. 38, §8, effective in 90 days [ 10/2/2008].