When Does A Physical Therapy Referral or Prescription Expire

Determining how long a physical therapy referral, also known as a prescription, is good for must take into account state practice act guidelines as well as third party payer guidelines.

Medicare Part B, for example, does not require a physical therapy referral, therefore it has no expiration date.

See the screenshot below from CMS Chapter 15.

Some state practice acts may require a patient be referred to physical therapy within the past 30-days for therapy services to be allowed.

The excerpt below shows how the Florida state practice act for physical therapy only requires a referral within 30-days of starting a plan of care IF the patient has never been diagnosed by a physician for the condition being treated.

Summary:

Once you have determined referral guidelines from within your state practice act and as determined by the involved third party payer, then you may develop a policy to ensure referrals, prescriptions, and orders for physical therapy are both timely and compliant.