What Happened in Wisconsin is Good News for all Physical Therapists!

This is big news for all physical therapists, not just those practicing in Wisconsin. What happens in one part of the country tends to get rolled out in others, and this sets a precedent for other states to follow. It also supports the growing trend that I talk about frequently that involves all healthcare providers reaching to practice to the maximum of their licensure.

November 24, 2015 – Introduced by Representatives Sanfelippo, Ballweg,
Duchow, Edming, Horlacher, Kitchens, Knodl, Kremer, Krug, Macco, A.
Ott, Quinn, Rohrkaste, Swearingen, Tauchen, C. Taylor, Thiesfeldt, Tittl
and Weatherston, cosponsored by Senators Wanggaard, Vukmir, Gudex,
Kapenga, Nass and Stroebel. Referred to Committee on Health.
AB549,1,3 1An Act to renumber and amend 448.50 (4) (b); to amend 462.04; and to create
2448.56 (7) of the statutes; relating to: the authority of physical therapists to
3order X-rays and granting rule-making authority.
Analysis by the Legislative Reference Bureau
This bill allows for X-rays to be ordered by physical therapists who satisfy
certain criteria.
Under current law, X-rays may generally only be performed if authorized
pursuant to a prescription or order issued by one of several types of licensed medical
professionals specified under current law. This bill adds licensed physical therapists
to this list of licensed medical professionals authorized to prescribe or order the use
of diagnostic X-ray equipment. The bill provides, however, that a licensed physical
therapist may only order X-rays if the physical therapist satisfies one of certain
conditions specified in the bill. In addition, the bill provides that the physical
therapist must, when ordering X-rays, communicate with the patient’s primary care
physician or an appropriate health care provider to ensure coordination of care,
unless certain criteria that are specified in the bill apply.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:

1Section 1. 448.50 (4) (b) of the statutes is renumbered 448.50 (4) (b) (intro.)
2and amended to read:

AB549,2,43 448.50 (4) (b) (intro.) “Physical therapy” does not include using any of the
AB549,2,8 51. Using roentgen rays or radium for any purpose, using except that “physical
6therapy” includes ordering X-rays to be performed by qualified persons, subject to
7s. 448.56 (7) (a), and using X-ray results to determine a course of care or to determine
8whether a referral to another health care provider is necessary.
AB549,2,10 92. Using electricity for surgical purposes, including cauterization, or
AB549,2,11 113. Prescribing drugs or devices.
AB549,2 12Section 2. 448.56 (7) of the statutes is created to read:
AB549,2,1513 448.56 (7) Ordering X-rays.   (a) A physical therapist may order X-rays to be
14performed by qualified persons only if the physical therapist satisfies one of the
15following qualifications, as further specified by the examining board by rule:
AB549,2,1616 1. The physical therapist holds a clinical doctorate degree in physical therapy.
AB549,2,1817 2. The physical therapist has completed a nationally recognized specialty
18certification program.
AB549,2,2019 3. The physical therapist has completed a nationally recognized residency or
20fellowship certified by an organization recognized by the examining board.
AB549,2,2221 4. The physical therapist has completed a formal X-ray ordering training
22program with demonstrated physician involvement.
AB549,2,2523 (b) When a physical therapist orders an X-ray, the physical therapist shall
24communicate with the patient’s primary care physician or an appropriate health care
25practitioner to ensure coordination of care, unless all of the following apply:

11. A radiologist has read the X-ray and not identified a significant finding.

AB549,3,22 2. The patient does not have a primary care physician.
AB549,3,43 3. The patient was not referred to the physical therapist by another health care
4practitioner to receive care from the physical therapist.
AB549,3 5Section 3. 462.04 of the statutes is amended to read:
AB549,3,13 6462.04 Prescription or order required. A person who holds a license or
7limited X-ray machine operator permit under this chapter may not use diagnostic
8X-ray equipment on humans for diagnostic purposes unless authorized to do so by
9prescription or order of a physician licensed under s. 448.04 (1) (a), a dentist licensed
10under s. 447.04 (1), a podiatrist licensed under s. 448.63, a chiropractor licensed
11under s. 446.02, an advanced practice nurse certified under s. 441.16 (2), or a
12physician assistant licensed under s. 448.04 (1) (f), or, subject to s. 448.56 (7) (a), a
13physical therapist licensed under s. 448.53.

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