Direct Access Advocacy Source: https://www.apta.org/advocacy/issues/direct-access-advocacy Format: Extracted web text, not an original PDF By using this site, you are consenting to our use of cookies. To find out more visit our privacy policy . Accept Cookies Direct Access Advocacy More needs to be done to improve direct access in states across the country. Improving direct access to physical therapist services has been a public policy priority for APTA for many years.  As of July 1, 2025, all 50 states, the District of Columbia, and the U.S. Virgin Islands have either provisional or unrestricted direct access to physical therapist services for evaluation and treatment. Even though patients may go directly to a physical therapist without a referral, some provisions tied to treatment absent a referral still persist in a number of states — despite evidence that unrestricted direct access benefits patients, providers, employers, payers, and the U.S. health care system. Why It Matters Direct access restrictions cause unnecessary delays for people who would benefit from treatment by a PT. Delays in care result in higher costs, decreased functional outcomes, and frustration for patients seeking physical therapy treatment. Eliminating arbitrary barriers results in timely, more effective care. Our Position Allowing individuals to make decisions regarding their health care is good policy. Eliminating the referral requirement makes health care more accessible to more people. We must amend current statutes at the state level to remove arbitrary limitations on direct access to physical therapy services. The State of Direct Access in the United States To continue to improve patient access to care, APTA’s report, “ State of Direct Access to Physical Therapist Services in the United States ,” is intended to address common concerns raised during direct access advocacy and implementation negotiations. Recommended Content Direct Access By State Resource Review each jurisdiction’s level of direct access to physical therapist services. Additional Direct Access Advocacy Content Policy Progress and Patient-First Thinking: Takeaways from the 2026 Maley Panel Article APTA State Chapters Record 48 Wins in 2025, Work Continues in 2026 Article APTA’s Report on Direct Access Is a Tool for Action News APTA’s latest advocacy resource helps members improve patient access, payment, and consumer awareness of direct access to PT services. State of Direct Access to Physical Therapist Services Report (Open Access) APTA’s "State of Direct Access to Physical Therapist Services" report is a strategic resource designed to equip health care leaders with the scientific evidence they need to address opposition to direct access and drive meaningful change. APTA Advocacy Leads to Direct Access for Millions Covered by Aetna Article Top APTA News Articles of 2024 News Here are five of the most popular articles viewed by your peers in 2024. Historic Wins: Last Severe Restrictions on Direct Access Eliminated News Recent changes in Alabama mean that all states now have either provisional or unrestricted access to physical therapy without a referral. APTA Advocacy Win: Defense Dept. to Roll Out System-Wide Direct Access to PTs News A new report from DOD says that positioning PTs as primary care providers for neuromusculoskeletal conditions is "entirely feasible." From PTJ: Seeing PT or Chiropractor First for Low Back Pain Is Less Costly Review Patients who first sought care from a physical therapist or chiropractor had fewer opioid prescriptions and MRIs after diagnosis. APTA Chapters Fuel State-Level Wins Roundup Growing participation in the PT Compact, expanded direct access, ability to order imaging, limits on prior authorization, and more.