February 26, 2007
SENATE BILL No. 197
DIGEST OF SB 197
(Updated February 26, 2007 3:13 pm - DI 104)
Citations Affected: IC 25-27.
Synopsis: Physical therapists. Allows a physical therapist to provide
subsequent treatment to a patient who was previously referred to the
physical therapist for the same condition if: (1) the referral was given
not more than 6 months before the request for subsequent treatment;
and (2) the physical therapist contacts the referring provider within
three days. Allows a physical therapist to evaluate a patient without a
referral, but requires the physical therapist to contact the patient's
appropriate provider and obtain a referral before providing treatment.
Requires a physical therapist to complete additional education in order
to receive an endorsement to perform spinal manipulation, adjustment,
or grade 5 mobilization. Specifies that a physical therapist may
perform sharp debridement only on the order of a physician. Removes
the authority that allows physical therapists to practice physical therapy
upon the order or referral of a psychologist.
Effective: July 1, 2007.
January 8, 2007, read first time and referred to Committee on Health and Provider
February 22, 2007, amended, reported favorably _ Do Pass.
February 26, 2007, read second time, amended, ordered engrossed.
February 26, 2007
First Regular Session 115th General Assembly (2007)
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SENATE BILL No. 197
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 25-27-1-1; (07)SB0197.2.1. -->
SECTION 1. IC 25-27-1-1 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 1. For the purposes of
(1) "Physical therapy" means the evaluation of, administration of,
or instruction in physical rehabilitative and habilitative
techniques, and procedures to evaluate, prevent, correct, treat,
alleviate, and limit physical disability, pathokinesiological
function, bodily malfunction, pain from injury, disease, and any
other physical disability,
or mental disorder,
(A) the use of physical measures, agents, and devices for
preventive and therapeutic purposes;
(B) neurodevelopmental procedures;
(C) the performance, interpretation, and evaluation of physical
therapy tests and measurements; and
(D) the provision of consultative, educational, and other
advisory services for the purpose of preventing or reducing the
incidence and severity of physical disability, bodily
malfunction, and pain.
(2) "Physical therapist" means a person who practices physical
therapy as defined in this chapter.
(3) "Physical therapist's assistant" means a person who assists in
the practice of physical therapy as defined in this chapter.
(4) "Board" refers to the medical licensing board.
(5) "Committee" refers to the Indiana physical therapy committee
established under section 4 of this chapter.
(6) "Person" means an individual.
(7) "Sharp debridement" means the removal of foreign
material or dead tissue from or around a wound, without
anesthesia and with generally no bleeding, through the use of:
(A) a sterile scalpel;
(D) tweezers; or
(E) other sharp medical instruments;
in order to expose healthy tissue, prevent infection, and
(8) "Spinal manipulation, adjustment, or grade 5
mobilization" means a manual or mechanical intervention
that may have velocity, lever, amplitude, or recoil and that:
(A) may carry a joint complex beyond the normal
physiological range of motion;
(B) is applied without exceeding the boundaries of
anatomical integrity of the joint complex or other
(C) is intended to result in a cavitation of the joint or a
reduction of a subluxation.
SOURCE: IC 25-27-1-2; (07)SB0197.2.2. -->
SECTION 2. IC 25-27-1-2 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2007]: Sec. 2. (a) Except as
otherwise provided in this chapter, it is unlawful for a person to:
practice physical therapy;
profess to be a physical therapist, physiotherapist, or physical
therapy technician or to use the initials "P.T.", "P.T.T.", or
"R.P.T.", or any other letters, words, abbreviations, or insignia
indicating that the person is a physical therapist; or
assume the duties incident to physical therapy;
without first obtaining from the board a license authorizing the person
to practice physical therapy in this state.
(b) Except as provided in section 2.5 of this chapter,
unlawful for a person to practice physical therapy other than upon the
order or referral of a physician, podiatrist,
or dentist holding an unlimited license to practice medicine, podiatric
medicine, psychology, chiropractic, or dentistry, respectively. It is
unlawful for a physical therapist to use the services of a physical
therapist's assistant except as provided under this chapter. For the
purposes of this subsection, the function of:
(2) doing research;
(3) providing advisory services; or
(4) conducting seminars on physical therapy;
is not considered to be a practice of physical therapy.
(c) Except as otherwise provided in this chapter, it is unlawful for
a person to act as a physical therapist's assistant or to use initials,
letters, words, abbreviations, or insignia indicating that the person is a
physical therapist's assistant without first obtaining from the board a
certificate authorizing the person to act as a physical therapist's
assistant. It is unlawful for the person to act as a physical therapist's
assistant other than under the direct supervision of a licensed physical
therapist who is in responsible charge of a patient or under the direct
supervision of a physician. However, nothing in this chapter prohibits
a person licensed or registered in this state under another law from
engaging in the practice for which the person is licensed or registered.
These exempted persons include persons engaged in the practice of
osteopathy, chiropractic, or podiatric medicine.
(d) Except as provided in section 2.5 of this chapter, this chapter
does not authorize a person who is licensed as a physical therapist or
certified as a physical therapist's assistant to:
(1) evaluate any physical disability
or mental disorder except
upon the order or referral of a physician, podiatrist, psychologist,
chiropractor, or dentist;
(2) practice medicine, surgery (as described in
IC 25-22.5-1-1.1(a)(1)(C)), dentistry, optometry, osteopathy,
psychology, chiropractic, or podiatric medicine; or
(3) prescribe a drug or other remedial substance used in medicine.
SOURCE: IC 25-27-1-2.5; (07)SB0197.2.3. -->
SECTION 3. IC 25-27-1-2.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2007]: Sec. 2.5. (a) A physical therapist may evaluate an
individual without a referral from a provider described in section
2(b) of this chapter. However, the physical therapist:
(1) shall contact the individual's appropriate provider for a
referral not later than three (3) business days after the
physical therapist evaluates the individual; and
(2) shall obtain a referral from the individual's appropriate
provider before providing treatment to the individual.
(b) Notwithstanding subsection (a) and except as provided in
section 3.5 of this chapter, a physical therapist may provide
subsequent treatment of a condition to an individual who was
previously referred to the physical therapist for the same condition
if the referral that authorized the previous treatment under section
2(b) of this chapter was given not more than six (6) months before
the date the individual requests subsequent treatment from the
physical therapist. However, the physical therapist shall consult
with the individual's original referring provider not later than
three (3) days after the physical therapist provides subsequent
treatment to the individual under this subsection.
SOURCE: IC 25-27-1-3.3; (07)SB0197.2.4. -->
SECTION 4. IC 25-27-1-3.3 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2007]: Sec. 3.3. (a) A physical therapist may not perform a spinal
manipulation, adjustment, or grade 5 mobilization unless the
physical therapist has received an endorsement to perform the
procedure by completing the additional education required in this
(b) The board shall issue an endorsement to a physical therapist
to perform a spinal manipulation, adjustment, or grade 5
manipulation if the physical therapist meets the additional
requirements in this section.
(c) In order to perform a spinal manipulation, adjustment, or
grade 5 mobilization, the physical therapist must satisfy the
following additional education requirements:
(1) At least three hundred ninety (390) credit hours, of which:
(A) at least five thousand six hundred (5,600) hours are
classroom hours that consist of at least:
(i) four hundred (400) hours of classroom instruction;
(ii) eight hundred (800) hours of supervised clinical
training, including certified and supervised manipulation
of at least two hundred fifty (250) different, alive
individuals, and of which at least two hundred (200) of
these manipulations are spinal manipulations.
(2) Seventy-five (75) assessments of patients through direct
The course description for a class taken under this subsection must
be equivalent to a course taken by a licensed chiropractor,
osteopath, or physician.
(d) In order to maintain an endorsement issued under this
section, a physical therapist who obtains the endorsement must
complete twelve (12) hours of continuing education per year, of
which at least six (6) hours are concerning spinal manipulation,
adjustment, or grade 5 mobilization.
SOURCE: IC 25-27-1-3.5; (07)SB0197.2.5. -->
SECTION 5. IC 25-27-1-3.5 IS ADDED TO THE INDIANA CODE
AS A NEW
SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2007]: Sec. 3.5. A physical therapist may not perform sharp
debridement unless the physical therapist performing the sharp
debridement is acting on the order of a physician licensed under:
(1) IC 25-22.5; or
(2) IC 25-29.