Direct Access Physical Therapy


For a long time, people in Texas did not have a direct pathway to access physical therapy services. In the traditional approach, Physical Therapists could evaluate patients but not initiate treatment without a referral from a primary care physician. The introduction of direct access in Texas grants numerous advantages for people seeking rehabilitation and reduces the average total health care cost.

Suppose someone approached me at the park and said, Jose, I know you’re a Physical Therapist. I see your stuff. I know you can help me. Can I go to your practice tomorrow morning? Previously, I would’ve had to deny this patient for direct services and instead have them schedule an appointment with their primary care physician for a referral.

However, this all changed in September 2019 with the passing of House Bill 29, which allows for direct access to Physical Therapy without obtaining a physician’s referral. By eliminating the traditional physician referral requirement, direct access streamlines the healthcare process by expediting treatment initiation and granting patients autonomy over their health. Despite this progress, there are currently limitations to direct access in Texas. The length of time a Physical Therapist can provide care is limited to 10 or 15 days, depending on their experience and qualifications. Afterward, a physician’s referral is required to continue the service.

Despite these constraints, it has continued empowering patients and providers alike in Texas, inspiring entrepreneurs like me. I formed Moveo Performance in 2021, an outpatient orthopedic private practice physical therapy clinic. Our clinic features a team of practitioners and is located at a specialized facility in North McAllen. With direct access, Moveo Performance can deliver timely service to its patients and allow physical therapists to fulfill their practice to a greater extent.

Although the State of Texas made a significant milestone in 2019 with direct access privileges, we continue to advocate for less restrictive guidelines in physical therapy. At the national level, all physical therapy programs have been doctoral-level programs for the past 15 years, providing extensive knowledge for the diagnosis process.

With direct access, Moveo can deliver care promptly and efficiently for those who require physical therapy. Their website allows patients to schedule a consultation and determine if their insurance plan will cover the treatment. For patients without insurance, Moveo can provide alternative payment options. Moveo will provide an individualized plan of treatment in accordance with their ailments and unique services, including soft tissue mobilization, dry needling, and joint mobilization.

“I knew I had a force injury and needed a consult but didn’t know where to go. So, I went online to look up a Physical Therapist, accessed the website for Moveo, and completed the intake evaluation form. The team was able to set me up for an initial evaluation pretty much the next day,” said Alejandro Ballesteros, a patient of Moveo Performance with a grade one ankle sprain.

After contacting Moveo Performance, our team will contact the patient to schedule an initial evaluation and determine the proper care plan for each individualized case. We can help guide you to the next step if you have a more severe injury. Some of these options may be consulting with a pain management physician or orthopedic surgeon or returning to your primary care physician to continue to receive physical therapy services beyond the 15-day mark with a referral.

The ability of Physical Therapists to operate with direct access is transformative to the practice of physical therapy and the lives of patients who positively benefit from its services. It gives practitioners greater autonomy, expands their ability to reach the community, and gives the patient expedited access to care.


Dr. Jose Suarez