BILL ANALYSIS C.S.H.B. 4099 By: Harris Davila Public Health Committee Report (Substituted) BACKGROUND AND PURPOSE The bill author has informed the committee that many Texans, whether they're recovering from surgery, managing chronic pain, or working to regain strength and mobility after an injury and need physical therapy, are often delayed in receiving care because of referral requirements, paperwork, and costs just to begin treatment. The bill author has also informed the committee that current state law limits the period during which a licensed physical therapist may treat a patient without a referral to 10 or 15 consecutive business days, as applicable, depending on the educational background of the physical therapist, which is fewer days than what many other states permit. The bill author has further informed the committee that these restrictions can not only delay care but can lead to worsened outcomes, higher costs, and greater strain on the health care system. C.S.H.B. 4099 seeks to create accessible, preventative health options and expand direct access to physical therapy by extending the period during which a physical therapist may treat a patient without a referral to 30 consecutive days. CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision. RULEMAKING AUTHORITY It is the committee's opinion that rulemaking authority is expressly granted to the Texas Board of Physical Therapy Examiners in SECTION 3 of this bill. ANALYSIS C.S.H.B. 4099 amends the Occupations Code to change the period during which a licensed physical therapist may treat a patient without a referral from not more than 10 consecutive business days to not more than 30 consecutive calendar days, if the physical therapist meets the following criteria, as provided under current law: has been licensed to practice physical therapy for at least one year; is covered by the applicable professional liability insurance; and either has completed at least 30 hours of continuing competence activities in the area of differential diagnosis or possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education. C.S.H.B. 4099 repeals Section 453.301(a-2), Occupations Code, which authorizes a physical therapist to treat a patient for not more than 15 consecutive business days without a referral if the physical therapist possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education and either has completed a residency or fellowship or is certified by an entity approved by the Texas Board of Physical Therapy Examiners (TBPTE). C.S.H.B. 4099 requires TBPTE, not later than December 1, 2025, to adopt rules necessary to implement the bill's provisions. EFFECTIVE DATE September 1, 2025. COMPARISON OF INTRODUCED AND SUBSTITUTE C.S.H.B. 4099 differs from the introduced in minor or nonsubstantive ways by conforming to certain bill drafting conventions.
BILL ANALYSIS
# BILL ANALYSIS
C.S.H.B. 4099
By: Harris Davila
Public Health
Committee Report (Substituted)
C.S.H.B. 4099
By: Harris Davila
Public Health
Committee Report (Substituted)
BACKGROUND AND PURPOSE The bill author has informed the committee that many Texans, whether they're recovering from surgery, managing chronic pain, or working to regain strength and mobility after an injury and need physical therapy, are often delayed in receiving care because of referral requirements, paperwork, and costs just to begin treatment. The bill author has also informed the committee that current state law limits the period during which a licensed physical therapist may treat a patient without a referral to 10 or 15 consecutive business days, as applicable, depending on the educational background of the physical therapist, which is fewer days than what many other states permit. The bill author has further informed the committee that these restrictions can not only delay care but can lead to worsened outcomes, higher costs, and greater strain on the health care system. C.S.H.B. 4099 seeks to create accessible, preventative health options and expand direct access to physical therapy by extending the period during which a physical therapist may treat a patient without a referral to 30 consecutive days.
CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY It is the committee's opinion that rulemaking authority is expressly granted to the Texas Board of Physical Therapy Examiners in SECTION 3 of this bill.
ANALYSIS C.S.H.B. 4099 amends the Occupations Code to change the period during which a licensed physical therapist may treat a patient without a referral from not more than 10 consecutive business days to not more than 30 consecutive calendar days, if the physical therapist meets the following criteria, as provided under current law: has been licensed to practice physical therapy for at least one year; is covered by the applicable professional liability insurance; and either has completed at least 30 hours of continuing competence activities in the area of differential diagnosis or possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education. C.S.H.B. 4099 repeals Section 453.301(a-2), Occupations Code, which authorizes a physical therapist to treat a patient for not more than 15 consecutive business days without a referral if the physical therapist possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education and either has completed a residency or fellowship or is certified by an entity approved by the Texas Board of Physical Therapy Examiners (TBPTE). C.S.H.B. 4099 requires TBPTE, not later than December 1, 2025, to adopt rules necessary to implement the bill's provisions.
EFFECTIVE DATE September 1, 2025.
COMPARISON OF INTRODUCED AND SUBSTITUTE C.S.H.B. 4099 differs from the introduced in minor or nonsubstantive ways by conforming to certain bill drafting conventions.
BACKGROUND AND PURPOSE
The bill author has informed the committee that many Texans, whether they're recovering from surgery, managing chronic pain, or working to regain strength and mobility after an injury and need physical therapy, are often delayed in receiving care because of referral requirements, paperwork, and costs just to begin treatment. The bill author has also informed the committee that current state law limits the period during which a licensed physical therapist may treat a patient without a referral to 10 or 15 consecutive business days, as applicable, depending on the educational background of the physical therapist, which is fewer days than what many other states permit. The bill author has further informed the committee that these restrictions can not only delay care but can lead to worsened outcomes, higher costs, and greater strain on the health care system. C.S.H.B. 4099 seeks to create accessible, preventative health options and expand direct access to physical therapy by extending the period during which a physical therapist may treat a patient without a referral to 30 consecutive days.
CRIMINAL JUSTICE IMPACT
It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY
It is the committee's opinion that rulemaking authority is expressly granted to the Texas Board of Physical Therapy Examiners in SECTION 3 of this bill.
ANALYSIS
C.S.H.B. 4099 amends the Occupations Code to change the period during which a licensed physical therapist may treat a patient without a referral from not more than 10 consecutive business days to not more than 30 consecutive calendar days, if the physical therapist meets the following criteria, as provided under current law:
has been licensed to practice physical therapy for at least one year;
is covered by the applicable professional liability insurance; and
either has completed at least 30 hours of continuing competence activities in the area of differential diagnosis or possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education.
C.S.H.B. 4099 repeals Section 453.301(a-2), Occupations Code, which authorizes a physical therapist to treat a patient for not more than 15 consecutive business days without a referral if the physical therapist possesses a doctoral degree in physical therapy from a program that is accredited by the Commission on Accreditation in Physical Therapy Education or an institution that is accredited by an agency or association recognized by the U.S. secretary of education and
either has completed a residency or fellowship or is certified by an entity approved by the Texas Board of Physical Therapy Examiners (TBPTE).
C.S.H.B. 4099 requires TBPTE, not later than December 1, 2025, to adopt rules necessary to implement the bill's provisions.
EFFECTIVE DATE
September 1, 2025.
COMPARISON OF INTRODUCED AND SUBSTITUTE
C.S.H.B. 4099 differs from the introduced in minor or nonsubstantive ways by conforming to certain bill drafting conventions.