Tuesday, July 01, 2014RSS Feed

New Michigan Law Means All 51 US Jurisdictions Allow Direct Access to PTs

The people of Michigan are better off—and the physical therapy profession

has reached an important milestone—now that legislation has been signed

into law allowing allow patients in Michigan to go directly to a physical

therapist (PT) for evaluation and treatment without a physician’s referral. The

legislative victory now means that all 50 states and the District of Columbia

allow for some form of direct access to PTs for evaluation and treatment.

SB 690, signed into law by Gov Rick Snyder, was sponsored by Sen John

Moolenaar and promoted by the Michigan Chapter of APTA (MPTA). The new

law creates the option for patients to see a PT without a referral or

prescription from a physician for up to 21 days or 10 treatment visits, and


will also allow patients to see a PT directly for injury prevention and fitness

promotion, with no time or visit limit. SB 690 also strengthens the

profession by specifying that only licensed PTs may use the term “doctor of

physical therapy” in connection with their services. A similar bill was

sponsored in the Michigan House of Representatives by Rep Margaret


The passage of this legislation is the culmination of many years of

hard-fought effort on the part of MPTA that at times faced significant


“The goal of direct access to physical therapy in Michigan has been 34 years

in the making,” said MPTA President Sue Talley, PT, DPT, C/NDT, in a news

release. “This achievement would not have been possible without the

commitment of multiple MPTA presidents, legislative chairs, the grass roots

efforts of our members and patients, and Sen Moolenaar and Rep O’Brien."

“This is a significant milestone for the people of Michigan and for the

physical therapy profession,” said Paul A. Rockar Jr, PT, DPT, MS, president of

APTA. “APTA has long advocated for improved patient access to physical

therapists, and I applaud Michigan’s achievement in making this policy a


The milestone of achieving some form of direct access to treatment in all 51

US jurisdictions comes on the heels of achieving direct access to evaluation

throughout the US in 2013. While notable in its own right, the achievement

sets the stage for association efforts to improve access in some states that

have more restrictive direct access laws that "are not based on evidence or

on the best interests of the patient,” according to Rockar.

The new Michigan law will take effect January 1, 2015. APTA provided a

direct access grant to the Michigan Chapter to support its efforts on SB 690.



CGFNS University today announced the launch of a new service to assist internationally educated physical therapists and physical therapist assistants in developing education remediation plans to meet requirements of evaluation tools for licensure and immigration. The eCoach Learning Services Physical Therapy Remediation Program offers applicants one-on-one consultation with a physical therapist who serves as a remediation coach to develop a remediation plan that addresses educational deficiencies identified through the Coursework Tool evaluations.

CGFNS International, and its independent division, International Consultants of Delaware (ICD), have provided education evaluations of internationally educated physical therapists and physical therapist assistants for over 35 years. Many of these evaluations have identified deficiencies in both the general and professional education content of the applicants’ programs of study. These deficiencies must be remediated before a physical therapist or physical therapist assistant can be declared eligible for the National Physical Therapy Examination by the Federation of State Boards of Physical Therapy (FSBPT).

“Applicants with deficiencies,” said Franklin A. Shaffer, EdD, RN, FAAN and CEO of CGFNS International, “have expressed difficulty in identifying schools and programs in which they can make up deficiencies, and have contacted CGFNS and ICD for assistance. We are pleased to now formally offer that assistance. The eCoach Learning Services Physical Therapy Remediation Program ensures preapproval of remediation course for re-evaluation under the same Coursework Tool through CGFNS International or ICD.”


CGFNS University facilitates organizational and professional learning by creating, distributing and managing knowledge. The University accomplishes CGFNS International’s Mission by conducting wide-ranging research; spearheading leadership and professional development; delivering online learning programs; encouraging business innovation; promoting an organizational culture that values learning; and supporting change management initiatives. For more information about the CGFNS University eCoach Learning Services Physical Therapy Remediation Program, go to the University’s website at www.cgfnsedu.org.

will go into effect on January 1, 2016.

 FSBPT’s goal is to give candidates a year notice prior to the requirements being implemented.

The requirements below will be in addition to the current FSBPT requirements.


FSBPT’s eligibility requirements are not the same as a state’s requirements for licensure.

Lifetime limit

Candidates will be able to take the exam a maximum of 6 times. An individual can take the NPTE for PTs 6 times and also take the NPTE for PTAs 6 times if he or she is otherwise qualified to do so. Candidates will still be allowed up to 3 attempts per year but now will have a 6 time total limit for the PT exam and a 6 time total limit for the PTA exam. Some states have lifetime limits that are more restrictive than FSBPT.

Low score limit

Candidates who receive two very low scores on the exam, currently defined as performing at or close to chance level (scale scores 400 and below), will not be allowed to test again. Candidates receiving one very low score on the exam will be notified that their performance is so far away from the minimal competence level that they will need to engage in serious remediation, like enrolling in another PT educational program, before attempting the NPTE again and that another score that is very low (400 or below) will result in a lifetime ban.

English Language Proficiency

Most foreign-educated physical therapists/assistants will need to pass the TOEFL and meet FSBPT’s current score requirements. There are some exemptions to the TOEFL requirement for individuals who are exempt under the USCIS regulations. TOEFL scores must be reported directly to FSBPT for purposes of determining eligibility for the NPTE. States may have different requirements for licensure and submitting TOEFL scores to the FSBPT does not mean that a candidate has met state licensure requirements. For information on each state’s TOEFL requirements visit the state pt board website  The current FSBPT TOEFL score requirement is in the table below.

TOEFL Section 

Minimum Score 









Substantial Equivalence

Graduates from non-CAPTE accredited institutions will need to demonstrate their education is equivalent to a CAPTE accredited education by having an authorized agency complete an evaluation using the current version of FSBPT’s Coursework Tool (CWT).
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