1 of 1 Performance & Rehab

Direct Access Physical Therapy Policy

Effective Date: 2026
Location: Missouri

1. Purpose

The purpose of this policy is to outline how 1 of 1 Performance & Rehab provides physical therapy services under Missouri’s Direct Access law (RSMo 334.506), ensuring compliance with state regulations while delivering safe, high-quality patient care.

2. Direct Access Eligibility

In the State of Missouri, a licensed physical therapist who:

• Holds a Doctor of Physical Therapy (DPT) degree, or

• Has five (5) years of clinical experience

may evaluate and initiate physical therapy treatment without a physician referral.

All treating therapists at 1 of 1 Performance & Rehab meet the qualifications required to provide services under Missouri’s Direct Access statute.

3. Treatment Limits Without Physician Referral

Under Missouri law, patients may receive physical therapy without a physician referral for:

• Up to ten (10) visits, OR

• Up to thirty (30) calendar days,

Whichever occurs first.

4. Requirement for Provider Consultation

If the patient requires continued physical therapy beyond 10 visits or 30 days:

• The treating physical therapist must consult with an approved healthcare provider (physician, chiropractor, PA, or APRN).

• Documentation must demonstrate measurable or functional improvement.

• The consultation will include:

  • Patient diagnosis and condition

  • Treatment provided

  • Objective progress

  • Proposed plan for continued care

Treatment may continue after consultation if deemed appropriate.

5. Conditions Outside Physical Therapy Scope

If at any time the patient presents with:

• Symptoms outside the scope of physical therapy

• Red flag medical concerns

• Lack of measurable progress

• Worsening condition

The patient will be referred to an appropriate healthcare provider immediately.

6. Insurance Considerations

Although Missouri law permits direct access:

• Some insurance carriers may require a physician referral for reimbursement.

• Patients using insurance benefits are responsible for verifying referral requirements with their insurer.

• As a primarily cash-based clinic, 1 of 1 Performance & Rehab is not responsible for insurance denials due to lack of referral.

7. Workers’ Compensation & Motor Vehicle Cases

Direct access does not override:

• Workers’ compensation authorization requirements

• Employer-designated provider rules

• Motor vehicle insurance claim procedures

Written authorization is required before treating work-related injuries under workers’ compensation.

8. Documentation & Compliance

The clinic will:

• Track visit count and calendar days from initial evaluation.

• Document objective measures at each visit.

• Document functional progress at reassessment.

• Initiate provider consultation when required.

• Maintain compliance with Missouri Physical Therapy Board regulations.

9. Patient Acknowledgment

Patients receiving services under direct access will be informed of:

• The 10-visit/30-day limit

• The possibility of provider consultation

• The clinic’s right to refer if medically necessary

Approved By:

Scott Brueckner, PT, DPT
Founder – 1 of 1 Performance & Rehab
Springfield/Republic, Missouri