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Governor Mike Parson recently signed Senate Bill (SB) 51 into law Thursday, allowing Missourians to have more direct access to physical therapy services. This new law streamlines the process for individuals seeking physical therapy care by reducing unnecessary government burdens and increasing patient access to physical therapy services.

SB 51 enables qualified physical therapists to treat patients without a prescription or referral from a physician, provide certain educational information, fitness or wellness programs, screenings, and consultations without a prescription or referral from a physician, and consult with an approved healthcare provider after every 10 visits or 30 days, whichever occurs first, before continuing therapy.

Physical therapists in the area have shared their thoughts on the new law, which they believe will have a positive impact on their patients.

Ellen Willis, the head rehab director at TCMH Physical Therapy, spoke about the impact the bill will have on the local community. 

Ellen Willis, MPT, CWS, CLT-LANA

“Physical therapists have been proponents of direct access for quite some time. The proposed legislation will not only allow physical therapists to practice with their full skill set but will also provide the community with improved access to the health care they need. With improved direct access to physical therapy services, a patient will be saving both time and money to get the services that will provide the most benefit for improved health outcomes. There will be decreased time waiting to see your provider and fewer insurance out-of-pocket copays. This may be a two to four-week improvement in getting the care you need. Physical therapists are very skilled at musculoskeletal evaluations but have the training to refer a patient back to providers if their medical expertise is needed. Overall, direct access benefits both the medical community and the patient,” said Willis.

Jennifer Schnieders, the immediate past president of APTA Missouri, worked closely on this issue for the past six years and attended the signing.

“The passage of Senate Bill 51 allows consumers to seek evaluation and treatment from a physical therapist without a referral or prescription from a healthcare provider. Historically, patients in Missouri had to first see an MD, DO, nurse practitioner, physician assistant, chiropractor, dentist or podiatrist, then be referred to a physical therapist. Until now, Missouri was one of just three states that did not allow patients to seek care directly from a physical therapist, the other two being Alabama and Mississippi. Missouri now joins its neighboring states in allowing direct access to physical therapy,” said Schnieders.

“The Missouri chapter of the American Physical Therapy Association has been working to change this for over 10 years, and multiple bills have been introduced in the state legislature to change this requirement. Historically, this legislation has been passed overwhelmingly in the House of Representatives, only to stall in the Senate. This year, a bill was introduced in both the House and Senate Chambers. Both have been heavily supported and the Senate Bill, sponsored by Sen. Karla Esslinger, was the first to cross the finish line. It is also the first bill to be Truly Agreed to and Finally Passed and signed by Governor Parson this year.”

From left: Jennifer Schnieders, immediate past president of APTA Missouri; Wendy Nall, current president of APTA Missouri; and Paula Burnett, APTA Missouri payment chair. Mayor Parson is seated with the bill.

Schnieders also spoke about the potential cost savings and improved outcomes for patients as a result of the new law.

“The provisions of this new law will allow Missourians who want to seek care from a physical therapist to do so with less out-of-pocket expense. Consumers will save on out-of-pocket costs for copayments, advanced imaging, and time or travel that accompanies seeing another provider first. Patients may also be seen more quickly by a physical therapist, usually within a week, rather than waiting several weeks to get an appointment with busy medical practices. When a patient comes to physical therapy without a referral, they can be seen for 10 visits or 30 calendar days, whichever occurs first. If the patient is making progress and showing improvement, the physical therapist will then communicate with the healthcare provider of the patient’s choice to discuss the continuation of care or the need for additional testing or referral. If no progress is being made, the physical therapist will refer the patient back to the provider of the patient’s choice for further evaluation.”

“Much data exists that supports improved outcomes when patients receive physical therapy early after an acute injury. Many insurance plans even delay coverage of advanced imaging until a course of physical therapy has been completed. Evidence shows that patients who are seen in PT before other medical management get better more quickly and with less cost to the insurance plan and the patient. This is a win for all Missourians, particularly those in rural areas with limited access to medical providers. Physical therapy is a cost-effective treatment option for musculoskeletal impairments that limit movement, function, and activity performance.”

Overall, SB 51 has been well received by the physical therapy community in Missouri, and they are optimistic that it will lead to improved access to care and better outcomes for their patients.

This legislation will go into effect on August 28, 2023. For more information on SB 51, click here.

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