In Michigan, Direct Access allows you to begin physical therapy (PT) without a physician’s prescription or referral. Here’s how it works under current law:
🧾 Key Legal Details
- Established by Public Act 260 of 2014 (effective January 1, 2015), Michigan permits patients to schedule an initial PT evaluation and treatment directly, without a doctor’s script Michigan Legislature+10Peak Performance Physical Therapy+10Luna Physical Therapy+10.
- You are allowed up to 10 visits or 21 days of PT—whichever comes first—before needing a physician referral or signed plan of care advancedphysicaltherapy.com+6aptami.org+6The Recovery Project+6.
- PTs must collaborate with physicians:
- If your condition surpasses their scope, they must refer you .
- After that 21-day or 10-visit period, a physician’s referral is required to continue Michigan Legislature+9Wachler & Associates Health Law Blog+9Luna Physical Therapy+9.
📋 Insurance & Billing
- While the law allows direct access, insurance plans may still require a signed plan of care from a doctor to cover PT services Michigan Legislature+10Peak Performance Physical Therapy+10The Recovery Project+10.
- Private-pay options are available if your insurance denies coverage under direct access Full Potential Physical Therapy+1Orthopaedic Rehab Specialists+1.
- Some insurance providers (e.g., Priority Health) may pay without a referral, but many — including Medicare — still enforce prior authorization The Recovery Project+5Full Potential Physical Therapy+5Orthopaedic Rehab Specialists+5.
🏛️ Future Changes Under Review
A proposed bill, Senate Bill 668, passed the Michigan Senate in November 2024. If enacted:
- It would eliminate the 10-visit/21-day limit , allowing indefinite direct access advancedphysicaltherapy.com+8Michigan Legislature+8aptami.org+8.
- Requires PTs to consult a physician if no progress within 60 days or if complications arise Peak Performance Physical Therapy+9Michigan Legislature+9Wachler & Associates Health Law Blog+9.
- PTs must also inform patients of any financial liability without a physician’s referral Michigan Legislature+1Wachler & Associates Health Law Blog+1.
- Law would take effect 180 days post-enactment.
✅ Practical Guidance
| If You Want to Start PT… | What You Need to Know |
|---|---|
| Immediately (within 10 visits/21 days) | You can go directly to a licensed PT in Michigan without a prescription. |
| To continue after that | A physician must sign off on a plan of care or referral. |
| Check insurance | Some insurers still require a physician-ordered plan for payment—ask them first. |
| Post-SB 668 (upon enactment) | You may have ongoing direct access if you’re showing progress, with physician consultation triggered only at 60 days or complications. |
🔍 What You Can Do Now
- 1. Call a local PT clinic(many promote “Direct Access”) and ask:
- “Can I receive 10 visits/21 days of PT without a referral?”
- “Will my insurance cover direct-access PT?”
- 2. Confirm your insurer’s policy—some still require a signed care plan.
- 3. Track legislative updates, especially on SB 668, to see when extended direct access becomes law.
Bottom Line
Michigan grants you restricted direct access—you can begin PT right away for initial treatment (up to 10 visits or 21 days) without a physician’s referral. But continuing care often requires a signed plan from a doctor for insurance coverage. A pending bill could significantly expand this access in the near future.
