1. As used in this section, "approved health care provider"
means a person holding a current and active license as a physician and
surgeon under this chapter, a chiropractor under chapter 331, a dentist
under chapter 332, a podiatrist under chapter 330, a physician assistant
under this chapter, an advanced practice registered nurse under chapter
335, or any licensed and registered physician, chiropractor, dentist, or
podiatrist practicing in another jurisdiction whose license is in good
standing.
2. A physical therapist shall not initiate treatment for a new injury
or illness without a prescription from an approved health care provider.
3. A physical therapist may provide educational resources and
training, develop fitness or wellness programs for asymptomatic persons, or
provide screening or consultative services within the scope of physical
therapy practice without the prescription and direction of an approved
health care provider.
4. A physical therapist may examine and treat without the
prescription and direction of an approved health care provider any person
with a recurring self-limited injury within one year of diagnosis by an
approved health care provider or a chronic illness that has been previously
diagnosed by an approved health care provider. The physical therapist
shall:
(1) Contact the patient's current approved health care provider
within seven days of initiating physical therapy services under this
subsection;
(2) Not change an existing physical therapy referral available to the
physical therapist without approval of the patient's current approved
health care provider;
(3) Refer to an approved health care provider any patient whose
medical condition at the time of examination or treatment is determined to
be beyond the scope of practice of physical therapy;
(4) Refer to an approved health care provider any patient whose
condition for which physical therapy services are rendered under this
subsection has not been documented to be progressing toward documented
treatment goals after six visits or fourteen days, whichever first occurs;
(5) Notify the patient's current approved health care provider prior
to the continuation of treatment if treatment rendered under this
subsection is to continue beyond thirty days. The physical therapist shall
provide such notification for each successive period of thirty days.
5. The provision of physical therapy services of evaluation and
screening pursuant to this section shall be limited to a physical
therapist, and any authority for evaluation and screening granted within
this section may not be delegated. Upon each reinitiation of physical
therapy services, a physical therapist shall provide a full physical
therapy evaluation prior to the reinitiation of physical therapy treatment.
Physical therapy treatment provided pursuant to the provisions of
subsection 4 of this section may be delegated by physical therapists to
physical therapist assistants only if the patient's current approved health
care provider has been so informed as part of the physical therapist's
seven-day notification upon reinitiation of physical therapy services as
required in subsection 4 of this section. Nothing in this subsection shall
be construed as to limit the ability of physical therapists or physical
therapist assistants to provide physical therapy services in accordance
with the provisions of this chapter, and upon the referral of an approved
health care provider. Nothing in this subsection shall prohibit an
approved health care provider from acting within the scope of their
practice as defined by the applicable chapters of RSMo.