Indiana Jurisprudence

Learning Outcomes

• List two sources of law that govern physical therapy practice in Indiana. 
• Identify the clinical scope of physical therapy practice in Indiana based on the most recent Indiana Physical Therapy Practice Act. 
• Describe how to maintain and renew your Physical Therapy license, including continuing competence requirements needed for license renewal.  

Introduction

Physical therapy practice in each state is established by that state's practice act. A state's practice act is decided by the legislature with administrative input and the state board of physical therapy. It is important to note that laws and rules, as well as standards and policies, can change at any time. It is the licensee’s responsibility to stay abreast of changes, and the best way to do that is through the Indiana Professional Licensing Agency's page on Physical Therapy and the American Physical Therapy Association (APTA).

Regulation of Physical Therapy in the State of Indiana is through the Indiana Code (Practice Act 25-27, Chapter 1-2), the Indiana Code Article 1 General Provisions, the Indiana Administrative Code, which are the Rules (Title 842 Indiana Board of Physical Therapy Article 1: Physical Therapists and Physical Therapist Assistants), Title 844, Article 6  Medical Licensing Board of Indiana, Physical Therapists and Physical Therapists' Assistants, the Indiana Board of Physical Therapy, and the Indiana Professional Licensing Agency. The Practice Act and the Administrative Code overlap somewhat, which you will notice as we go through the act and code below.   

Read the Practice Act in its entirety and become familiar with it; this course today will only be an overview and will touch on a few key highlights.  If you practice in multiple states, it is important to note that there are different practice acts in each state, so what may be okay to perform in that state may not be law in another.  

Statutes

A statute is the written will of the legislative body to solemnly express according to the forms necessary to constitute the state's law. The primary role of the courts is to carry out the legislature's intent.  In our case, legislative acts declare what the practice of physical therapy is – that is, what actions physical therapists can perform and what actions are prohibited.

Indiana Physical Therapy Practice Act and The Indiana Administrative Code 

The Indiana Physical Therapy Practice Act is contained in Indiana Code 25-27 and is available in Article 27, Regulation of Physical Therapists. The Indiana Administrative Code Title 842, Article 1, may be found here.  

As noted, the board may adopt new rules or amend existing ones between complete editions and, if so, list those on its website. Some recent changes have occurred in the past few years, and it is important to keep up to date with changes to the practice act.  

On the website, you can find information about licensing, including how to renew your license, telehealth certification for out-of-state practitioners, and  Physical Therapy Board information, including meeting dates, minutes, and agendas. 

The legislative purpose and intent of the Practice Act are to protect public health, safety, and welfare and to provide the state administrative control and supervision over the practice of physical therapy.

Title 25, Article 1 General Provisions

Title 25, 1 Evidence of License Applicant's Payment of Personal Property Taxes Required

It's illegal for any board, officer, or individual to issue a license to an Indiana resident without settling all outstanding property taxes. For licenses issued by the Bureau of Motor Vehicles, individuals with taxable possessions must present documentation, signed by the county treasurer, confirming full payment of taxes, regardless of any previous outstanding amounts. Conversely, if no taxable assets are owned, applicants must provide a statement from the county assessor attesting to an affidavit declaring no overdue taxes owed in Indiana.

Title 25, 1.1. Effect of Criminal Convictions on Licensed or Registered Persons

A "conviction of concern" refers to a criminal conviction that is closely associated with the specific duties and responsibilities of the occupation or profession for which an individual is either applying or already holds a license or certification, as determined by the board.

Except as outlined in the next four sections, a license or registration certificate required by law to engage in a business, profession, or occupation cannot be denied, revoked, or suspended solely due to an individual's conviction of an offense. However, the actions leading to the conviction may be considered to determine if the individual can be entrusted to serve the public in a specific capacity.

Furthermore, any individual licensed or certified under this title must inform the board in writing within ninety (90) days of any misdemeanor or felony criminal conviction, excluding traffic-related misdemeanors other than operating a vehicle under the influence of drugs or alcohol. This notification should be accompanied by a certified copy of the order or judgment, along with a letter of explanation.

Title 25-1-1.1-2 Suspension, Denial, or Revocation of a License or Certificate for Specified Convictions

A board, commission, or committee has the authority to suspend, deny, or revoke a professional license or certificate without requiring an investigation by the Office of the Attorney General if:

• The individual holding the license or certificate has been convicted of one of the offenses listed below, and
• The board, commission, or committee determines—after the individual appears in person—that the conviction affects their ability to perform their professional duties.

Convictions That May Lead to Disciplinary Action:

1. Possession of illegal substances

   • Cocaine or a narcotic drug (IC 35-48-4-6)
   • Methamphetamine (IC 35-48-4-6.1)
   • Any controlled substance (IC 35-48-4-7(a))

2. Fraudulent activity related to controlled substances

   • Fraudulently obtaining a controlled substance (IC 35-48-4-7(c))

3. Offenses related to drug paraphernalia

   • Manufacturing paraphernalia (IC 35-48-4-8.1(b)) – Class D felony (before July 1, 2014) or Level 6 felony (after June 30, 2014)
   • Dealing in paraphernalia (IC 35-48-4-8.5(b)) – Class D felony (before July 1, 2014) or Level 6 felony (after June 30, 2014)
   • Possession of paraphernalia (IC 35-48-4-8.3(b)) – Class D felony (before July 1, 2014) or Level 6 felony (after June 30, 2014)

4. Possession of marijuana and related substances

   • Includes hash oil, hashish, or salvia (IC 35-48-4-11) – Class D felony (before July 1, 2014) or Level 6 felony (after June 30, 2014)

5. Possession of synthetic drugs or related substances

   • Includes synthetic drugs, controlled substance analogs, or synthetic drug lookalike substances (IC 35-48-4-11.5) – Class D felony (before July 1, 2014) or Level 6 felony (after June 30, 2014)

6. Maintaining a common nuisance

   • If related to controlled substances (IC 35-48-4-13 (repealed) or IC 35-45-1-5)

7. Violations related to drug registration, labeling, or prescription forms

   • Under IC 35-48-4-14

8. Convictions for sex crimes

   • As defined under IC 35-42-4

9. Felony offenses that negatively impact professional fitness

This law ensures that professionals in licensed fields maintain integrity and responsibility in their practice. The disciplinary authority is granted only after an individual is given an opportunity to appear in person before the board, commission, or committee.

Title 25-1-1.1-3 Suspension or Revocation of License or Certificate; Conviction for Additional Drug-Related Offenses

A board, commission, or committee must revoke or suspend a professional license or certificate issued under this title if the individual holding the license or certificate is convicted of any of the following offenses:

1. Dealing Offenses

• Dealing in a controlled substance resulting in death 
• Dealing in or manufacturing cocaine or a narcotic drug 
• Dealing in methamphetamine
• Dealing in a Schedule I, II, or III controlled substance
• Dealing in a Schedule IV controlled substance 
• Dealing in a Schedule V controlled substance 
• Dealing in a counterfeit substance 
• Dealing in marijuana, hash oil, hashish, or salvia as a felony 

2. Manufacturing Offenses

• Manufacturing methamphetamine 
• Knowingly or intentionally manufacturing, advertising, distributing, or possessing with intent to manufacture, advertise, or distribute a falsely represented controlled substance (IC 35-48-4-4.6).
• Manufacturing or selling synthetic drugs or related substances, including:
  • Synthetic drugs 
  • Controlled substance analogs 
  • Substances falsely represented as controlled substances 

3. Other Drug-Related Violations

• Violating any federal or state drug law or rule related to wholesale legend drug distributors licensed under IC 25-26-14.

This provision ensures that individuals convicted of serious drug-related offenses are disqualified from holding professional licenses, thereby upholding the integrity of regulated professions.

Title 25-1-1.1-4 National Criminal History Background Check for Certain Licenses and Certificates; Release of Background Results; Random Audit

This section applies to anyone applying for an initial license. A national criminal history background check is required, which involves a review of records maintained by the Federal Bureau of Investigation (FBI) using fingerprinting or another reliable form of identification. Applicants must complete this background check at their own expense.

The state police department will provide the background check results to the Indiana Professional Licensing Agency. Additionally, licensing boards, commissions, and committees may conduct random audits on individuals renewing their licenses or certifications, requiring them to undergo a background check, also at their own expense.

Title 25-1-1.1-5 Memorandum of Understanding for Data Exchange; Use of Personal Information

This section establishes a data-sharing agreement between the state police and the Indiana Professional Licensing Agency.

Personal information" includes any details that can be used to identify an individual, such as:

• Photographs
• Social Security number
• Driver's license or identification card number
• Name
• Address
• Telephone number
• Fingerprints

It restricts the use of personal information obtained through this agreement to authorized government purposes related to licensure and law enforcement. 

Any personal information exchanged under this agreement must remain confidential and can only be used by government agencies for official purposes. Authorized agencies include:

• Prosecuting attorneys
• The Indiana Professional Licensing Agency and its affiliated boards, committees, and commissions
• Courts
• Law enforcement agencies
• The Office of the Attorney General

Title 25-1-1.1-6 Explicit List of Disqualifying Crimes Required; Use of Conviction; Criteria for Evaluating Applicant's Criminal History; Petition to Determine Whether Criminal Conviction Disqualifying

This section ensures that licensing requirements clearly define which criminal convictions may disqualify an applicant and prohibits vague terms like "moral turpitude" or "good character" as criteria for licensing decisions. Additionally, an arrest without a conviction cannot be considered in the licensing process.

A conviction can only be used to deny a license or certification if it is directly related to the duties and responsibilities of the profession. In most cases, a conviction cannot disqualify an individual for more than five years from the date of conviction unless the individual was convicted of a violent crime, a criminal sexual act, or committed another offense during the disqualification period.

Individuals with a conviction may petition the licensing board at any time to determine whether their criminal history would prevent them from obtaining a license or certification. To do so, they must submit an FBI background check at their own expense, along with any additional information requested by the board.

When reviewing a conviction, the board must consider:

• The severity and nature of the offense.
• The time elapsed since the crime occurred.
• Whether the conviction affects the applicant’s ability to perform job duties.
• Any evidence of rehabilitation or treatment.

If a license is denied due to a criminal conviction, the individual must receive a written notice explaining the reason for disqualification, the right to request a hearing, the earliest date they may reapply, and the consideration of rehabilitation efforts. Any decision to deny a license based on criminal history must be supported by clear and convincing evidence. In any appeal or court review, the board has the burden of proving that the conviction justifies the denial.

The board must respond to a petition within 60 days of receiving all required documentation. A processing fee of up to $25 may be charged for reviewing the petition. The board may also establish rules, including emergency provisions, to implement this section effectively.

Title 25-1-1.2-7 Order for Suspension or Denial of License; Notice to Practioner; Contents; Reinstatement

When the board receives a court order issued under IC 31-16-12-8 (or previous versions of the law before their repeal), it must either suspend the practitioner's license or deny an applicant's license application. Upon doing so, the board will mail a notice to the individual's last known address, informing them that their license suspension will take effect five business days after the notice is sent. The suspension will only be lifted ten business days after the board receives a court order allowing reinstatement. The notice also informs the practitioner of their right to petition the court for reinstatement.

The board cannot reinstate a suspended license until it receives an official court order allowing reinstatement.

Title 25-1-1.2-8 Notice of Probationary Status for Failure to Pay Child Support; Suspension; Reinstatement

If the board receives an order from the Bureau of Child Support, the affected practitioner’s license must be placed on probationary status. The board will send a notice to the individual stating that their license is on probation and will be suspended if the board does not receive clearance from the bureau within 20 days. The notice will also specify the amount of overdue child support and outline the steps necessary to resolve the delinquency, including paying the full amount owed or establishing a payment plan with an income withholding order.

The license will be suspended if the board does not receive confirmation within 20 days that the practitioner has resolved the child support issue. The board cannot reinstate a suspended or probationary license until it receives official notice from the bureau confirming that the delinquency has been addressed.

Title 25-1-4  Chapter 4 Continuing Education

The practitioner must provide the board with a sworn statement that they have fulfilled the continuing education requirements set by the board. The board will then forward this statement to the Indiana Professional Licensing Agency.

The practitioner must retain copies of their continuing education course completion certificates for three years after the licensing period in which the education was applied. The practitioner must provide these certificates to the board or agency upon request for a compliance audit. After each license renewal period, the agency, in consultation with the board, may randomly audit for compliance between 1-10% of the practitioners required to take continuing education courses.

Individuals called to active duty must be allowed to fulfill all continuing education requirements for professional or occupational licenses administered through the Indiana Professional Licensing Agency by distance learning methods.

A waiver from all or part of the continuing education requirement for a renewal period may be granted if the applicant was unable to fulfill the requirement due to a hardship resulting from:

1. Service in the armed forces during a substantial part of the renewal period.
2. An incapacitating illness or injury.
3. Other circumstances as determined 

Failure to comply; license suspension or refusal to reinstate; penalties; reinstatement requirements, 25-1-4-5

If a practitioner fails to comply with this chapter or IC 25-1-8-6 at the time of applying for license renewal or reinstatement, or if an audit under Section 3 identifies noncompliance, the board must take the following actions:

1. Send a notice of noncompliance by certified mail to the practitioner's last known address.
2. Require the practitioner to take corrective action as a condition of license renewal or reinstatement.
3. If the practitioner is renewing their license, issue a conditional license that remains in effect until compliance is achieved.

Practitioner Response to Notice of Noncompliance

Upon receiving a notice of noncompliance, the practitioner must respond within 21 days by either:

1. Requesting a Review: If the practitioner believes they are in compliance, they may request a review by submitting written proof of compliance to the board.
2. Accepting the Determination of Noncompliance: If the practitioner agrees with the board’s findings, they must:
   • Pay a civil penalty of up to $1,000 within 21 days (unless an exception applies under subsection (d)).
   • Complete any required continuing education credits within six months.
   • Comply with all other applicable licensing requirements.

Failure to Comply

If a practitioner does not fulfill the corrective actions required under subsection (b), the board must immediately suspend or deny reinstatement of their license and notify them by certified mail.

False or Misleading Compliance Statements

If a practitioner knowingly or intentionally provides false or misleading information about their compliance with continuing education requirements, the board may impose an additional civil penalty of up to $5,000.

License Reinstatement

The board will reinstate or fully renew a license (removing any conditional status) once the practitioner provides proof of full compliance with all licensing requirements.

Failure to comply; denial of license renewal or reinstatement; penalties, IC 25-1-4-6

If a practitioner applies for license renewal or reinstatement and the board determines they have failed to comply with this chapter or IC 25-1-8-6—either at the time of application or after an audit under Section 3—the board must take action if the practitioner has previously received a notice of noncompliance under Section 5(a) during the prior license period. In such cases, the board must:

1. Send a notice of noncompliance to the practitioner via certified mail.
2. Deny the practitioner's application for license renewal or reinstatement.

License Reinstatement Requirements

The board may reinstate a denied license only if the practitioner:

1. Pays a civil penalty as determined by the board, up to a maximum of $1,000.
2. Completes the required number of continuing education credit hours for the relevant license period.
3. Fully complies with all other licensing requirements under this chapter.

This ensures that practitioners consistently meet professional and educational standards before their licenses are renewed or reinstated.

Title 25 Article 1 Chapter 5 Indiana Professional Licensing Agency

The agency is responsible for employing the necessary staff, including specialists and professionals, to manage the administrative functions of the licensing boards in Indiana (including the physical therapy board). These responsibilities include organizing board meetings and communications, maintaining records of meetings and licensed professionals, administering exams, and managing license issuance and renewal.

Additional Agency Responsibilities

In addition to its administrative duties, the agency:

• Prepares a consolidated budget statement for all licensing boards (not just the physical therapy board). 
• Coordinates renewal cycles, exam schedules, and routine activities to improve efficiency and accessibility.
• Consolidates office space, recordkeeping, and data processing where feasible.
• Maintains the electronic registry of licensed professionals.
• Posts public meeting agendas at least 72 hours before meetings and minutes within 14 days of their adoption.
• Posts board vacancies within 14 days of occurrence.
• Establishes application procedures and ensures new forms are publicly available for at least 60 days before adoption.
• Sends applicants a notice of incomplete application items every 14 days until completion or up to one year after initiation.

License and Certification Renewal

The agency must notify license or certificate holders at least 90 days before expiration, informing them of renewal requirements and fees. If the agency fails to send this notice, the individual will not be penalized for failing to renew as long as they complete the renewal within 45 days after receiving the notice.

The agency must make application forms available at least 30 days before the submission deadline for licensing exams.

When processing a license renewal, the agency may require applicants to provide evidence that they still meet minimum licensing requirements and have not violated professional regulations. The agency must process renewal applications within 10 days of receiving all required documentation or within 24 hours if the applicant appears in person.

Delays and Investigations

If there is information suggesting a licensee may have committed a violation, the agency may delay renewal for up to 120 days to allow for an investigation. During this period, the agency must notify applicants that they are under review. Before the 120-day period ends, the board must take one of the following actions:

1. Deny the renewal after the applicant appears before the board.
2. Approve the renewal if all other conditions are met.
3. Renew the license but file a complaint against the applicant.
4. With the applicant’s agreement and a personal appearance, renew the license with probationary status.

If the applicant fails to appear before the board, the board may proceed with denial, renewal, or complaint filing.

Unless officially denied or suspended, a license remains valid throughout the investigation and decision-making process. If the board takes no action within 120 days, the license is automatically renewed. However, a renewal does not prevent the board from later imposing sanctions if the attorney general files a complaint.

Renewal Cycles and Application Abandonment

The agency can stagger renewal cycles for efficiency, but any changes require approval from the affected board or committee.

An application for a license, certification, or permit is considered abandoned if the applicant does not complete all requirements within one year of submission. However, the board may grant 30-day extensions for good cause. If an applicant submits a new application after abandonment, it is treated as a fresh application.

IC 25-1-5-4.6 Electronic applications; website information

Beginning January 1, 2024, all applications for new licenses, certificates, or renewals must be submitted electronically. However, individuals may request a paper application from the agency, which will establish the process for making such requests.

By February 1 of each year, the agency must publish the following data on its website for the previous calendar year:

1. The total number of new licenses and certificates issued, categorized by type.
2. The average processing time for new licenses and certificates from the date of completed application submission, categorized by type.
3. The total number of licenses and certificates renewed, categorized by type.

These requirements ensure a streamlined licensing process while maintaining transparency regarding licensing activity and efficiency.

IC 25-1-9-4 Standards of professional practice; findings required for sanctions; evidence of foreign discipline

A practitioner must conduct their practice in accordance with the standards set by the regulatory board for their profession. If, after a hearing, the board determines that a practitioner has violated these standards, they may impose disciplinary sanctions under Section 9. Grounds for disciplinary action include the following:

1. Fraud and Deception

   • Engaging in or assisting with fraud to obtain a license, including cheating on an exam.
   • Committing fraud or deception in professional services or activities.
   • Advertising services in a false or misleading manner.
   • Being convicted of fraud-related crimes, particularly in billing practices for Medicaid, Medicare, the Children's Health Insurance Program, or insurance claims.

2. Criminal Convictions

   • Being convicted of a crime that affects the practitioner's ability to practice competently.
   • Being convicted of a crime that poses a risk to public safety.

3. Regulatory Violations

   • Knowingly violating state or federal laws or regulations related to the profession.

4. Unfitness to Practice

   • Professional incompetence, including performing duties beyond one's training or experience.
   • Failing to stay updated on current professional knowledge and practices.
   • Suffering from a physical or mental disability that impairs professional performance.
   • Addiction or severe dependence on alcohol or drugs that jeopardizes public safety.

5. Unethical Conduct

   • Engaging in lewd or immoral conduct while providing services.
   • Allowing one’s name or license to be used by an unqualified individual to provide services.
   • Having disciplinary action taken in another state or jurisdiction for similar reasons.

6. Drug Violations

   • Diverting prescription drugs for unauthorized use.
   • Illegally prescribing or administering narcotics or addictive substances to a known addict.

7. Failure to Comply with Sanctions

   • Not adhering to an order imposing disciplinary action.

8. Sexual Misconduct

   • Engaging in sexual contact with a patient or using the practitioner-patient relationship to solicit sexual contact.
   • Note: Providing healthcare services to a spouse does not fall under this violation.

9. Financial Misconduct

   • Attempting to collect unauthorized payments from patients enrolled in a health maintenance organization (HMO).

10. Complicity in Misconduct

• Assisting another person in committing an act that would warrant disciplinary action.

11. Failure to Report Child Abuse

• Not reporting suspected child abuse to the Department of Child Services or law enforcement as required by law.

If a practitioner has faced disciplinary action in another jurisdiction, a certified record of that action is considered conclusive evidence for similar action under this section.

IC 25-1-9-4.5  Failure to Provide Human Trafficking Information

If a practitioner encounters evidence suggesting that a patient may be a victim of human trafficking, and a similarly trained professional would reasonably reach the same conclusion, the practitioner is required to provide the patient with information about available services and resources. This includes the contact number for the National Human Trafficking Hotline.

In addition to the professional conduct requirements, a practitioner may face disciplinary action under Section 9 if, after a hearing, the board determines that they failed to provide the required information to a suspected trafficking victim.

Title 25 Article 27 Physical Therapists, Chapter 1 Regulation of Physical Therapists

Definitions Title 25, Article 27-1-1

Definitions give us a common framework to begin a discussion on a particular topic or issue. Please review the definitions provided by the Indiana Practice Act below for understanding throughout the rest of the course.

• Physical therapy- care and services provided by or under the direction and supervision of a physical therapist that includes any of the following:
  • (A) Examining, evaluating, and conducting testing (as defined in subdivision (16)) on patients with mechanical, physiological, or developmental impairments, functional limitations, and disabilities or other health and movement-related conditions to determine a physical therapy diagnosis
  • (B) Alleviating impairments, functional limitations, and disabilities by designing, implementing, and modifying treatment interventions that may include therapeutic exercise, functional training in the home, community, or work integration or reintegration that is related to physical movement and mobility, manual therapy, including soft tissue and joint mobilization or manipulation, therapeutic massage, prescription, application, and fabrication of assistive, adaptive, orthotic, protective, and supportive devices and equipment, including prescription and application of prosthetic devices and equipment, airway clearance techniques, integumentary protection and repair techniques, debridement and wound care, physical agents or modalities, mechanical and electrotherapeutic modalities, and patient-related instruction.
  • Using solid filiform needles to treat neuromusculoskeletal pain and dysfunction (dry needling), after completing board-approved continuing education and complying with applicable board rules. However, a physical therapist may not engage in the practice of acupuncture unless the physical therapist is licensed under IC 25-2.5
  • Reducing the risk of injury, impairment, functional limitation, and disability, including the promotion and maintenance of fitness, health, and wellness in populations of all ages
  • Engaging in administration, consultation, education, and research
• Physical therapist- a person who is licensed under this chapter to practice physical therapy.
• Physical therapist assistant- a person who is certified under this chapter and assists a physical therapist in selected components of physical therapy treatment interventions
• Board- refers to the Indiana Board of Physical Therapy
• Physical therapy aide- support personnel who perform designated tasks related to the operation of physical therapy services
• Person- an individual
• Sharp debridement- removal of foreign material or dead tissue from or around a wound, without anesthesia and with generally no bleeding, through the use of sharp medical instruments such as a sterile scalpel, scissors, forceps, and tweezers to expose healthy tissue, prevent infection and promote healing.  
• Spinal manipulation- a method of skillful and beneficial treatment by which a physical therapist uses direct thrust to move a joint of the patient's spine beyond its normal range of motion, but without exceeding the limits of anatomical integrity. 
• Tasks- activities that do not require the clinical decision-making of a physical therapist or the clinical problem-solving of a physical therapist assistant.
• Competence- the application of knowledge, skills, and behaviors required to function effectively, safely, ethically, and legally within the patient's role and environment.
• Continuing competence- the process of maintaining and documenting competence through ongoing self-assessment, development, and implementation of a personal learning plan and subsequent reassessment.
• State- a state, territory, or possession of the United States, the District of Columbia, or the Commonwealth of Puerto Rico.
• Direct supervision- means that a physical therapist or physical therapist assistant is physically present and immediately available to direct and supervise tasks related to patient management.
• General supervision- supervision provided by a physical therapist who is available by telecommunication.
• Onsite supervision- supervision provided by a physical therapist who is continuously onsite and present in the department or facility where services are provided. The supervising therapist must be immediately available to the person being supervised and maintain continued involvement in the necessary aspects of patient care.
• Conduct testing- standard methods and techniques used to gather data about a patient, including, subject to section 2.5(c) of this chapter, electrodiagnostic and electrophysiologic tests and measures. The term does not include x-rays.
• Physical therapy diagnosis- a systematic examination, evaluation, and testing process that culminates in identifying the dysfunction toward which physical therapy treatment will be directed. The term does not include a medical diagnosis.

Unlawful Practices, Providing Mandated School Services 25-27-1-2 

Sec 2. (a). It is unlawful for a person or business entity to do the following (unless noted elsewhere in the practice act and under IC 25-27-2):

• (1) Practice physical therapy without obtaining a license first from the board, allowing the person to practice physical therapy in the state of Indiana.
• (2) Profess to be or promote an employee to be a physical therapist, physiotherapist, doctor of physiotherapy, doctor of physical therapy, or registered physical therapist or to use the initials "P.T.", "D.P.T.", "L.P.T.", or "R.P.T.", or any other letters, words, abbreviations, or insignia indicating that physical therapy is provided by a physical therapist unless physical therapy is provided by or under the direction of a physical therapist.
• (3) Advertise services for physical therapy or physiotherapy services unless the individual performing those services is a physical therapist.

(b) Except as provided in subsection (e) and section 2.5 of this chapter, it is unlawful for a person to practice physical therapy other than upon the order or referral of a physician, podiatrist, psychologist, chiropractor, dentist, nurse practitioner, or physician assistant holding an unlimited license to practice medicine, podiatric medicine, psychology, chiropractic, dentistry, nursing, or as a physician assistant, respectively. It is unlawful for a physical therapist to use the services of a physical therapist assistant except as provided under this chapter. For this subsection, the function of teaching, doing research, providing advisory services, or conducting seminars on physical therapy is not considered to be a practice of physical therapy.

(c) Except as otherwise provided in this chapter and IC 25-27-2, it is unlawful for a person to profess to be or act as a physical therapist assistant or to use the initials "P.T.A." or any other letters, words, abbreviations, or insignia indicating that the person is a physical therapist assistant without first obtaining from the board a certificate authorizing the person to act as a physical therapist assistant. It is unlawful for the person to act as a physical therapist assistant other than under the general supervision of a licensed physical therapist who is in charge of a patient. However, nothing in this chapter prohibits a person licensed or registered in this state under another law from engaging in the practice for which the person is licensed or registered. These exempted persons include persons engaged in the practice of osteopathic medicine, chiropractic, or podiatric medicine.

(d) Except as provided in section 2.5 of this chapter, this chapter does not authorize a person who is licensed as a physical therapist or certified as a physical therapist assistant to:

• evaluate any physical disability or mental disorder except upon the order or referral of a physician, podiatrist, psychologist, chiropractor, physician assistant, nurse practitioner, or dentist;
• practice medicine, surgery (as described in IC 25-22.5-1-1.1(a)(1)(C)), dentistry, optometry, osteopathic medicine, psychology, chiropractic, or podiatric medicine; or
• prescribe a drug or other remedial substance used in medicine.

(e) When referred by a licensed school psychologist, a licensed physical therapist who is a school corporation employee or contractor can deliver mandated school services to a student within the physical therapist's scope of practice.

Evaluations and Treatment Without a Referral; Exceptions; Testing Certification 27-1-2.5 

Sec. 2.5

A physical therapist may evaluate and treat an individual during a period not to exceed forty-two calendar days beginning with the date of the initiation of treatment without a referral from a provider (except in regards to performing spinal manipulation-see below). However, if the individual needs additional treatment from the physical therapist after forty-two calendar days, the physical therapist must obtain a referral from the provider.

A physical therapist may not perform spinal manipulation of the spinal column or the vertebral column unless:

• The physical therapist is acting on the order or referral of a physician, an osteopathic physician, or a chiropractor; AND
• The referring physician, osteopathic physician, or chiropractor has examined the patient before issuing the order or referral.

A physical therapist who conducts electrophysiologic or electrodiagnostic testing must obtain and maintain the American Board of Physical Therapy Specialties Clinical Electrophysiologic Specialist Certification.

Practice of Certain Occupations or Professions and First Aid Not Prohibited 27-1-3.1 

Sec. 3.1. This chapter does not prohibit any of the following:

• The practice of any occupation or profession for which a person is licensed, certified, or registered in Indiana by a state agency. The persons exempted by this subdivision include persons licensed, certified, or registered to practice osteopathic medicine, chiropractic, or podiatric medicine.
• The practice of any health care occupation or profession by a person practicing within the scope of the person's education and experience.
• The performance of any first aid procedure incidental to a person's employment or volunteer duties.
• The performance of an emergency first aid procedure by any person.

Except as provided in section 2(a)(3) of this chapter, the provision of the following by a chiropractor licensed under IC 25-10:

• Physical therapy modality services
• Physical rehabilitation services
• Therapeutic procedures
• Tests and measurements
• Therapeutic devices
• Physiotherapy, as included in the chiropractic licensure examination

Exempt Persons 27-1-3.3 

Sec. 3.3. The following persons are exempt from the licensure or certification requirements of this article:

• Students on Clinical Affiliations. A person in an entry-level professional education program approved by the board who is satisfying supervised clinical education requirements related to the person's physical therapist education while under the onsite supervision of a physical therapist.
• Armed Forces. A physical therapist practicing in the armed forces of the United States, United States Public Health Service, or United States Department of Veterans Affairs under federal regulations for jurisdiction licensure of health care providers. However, if the person, while federally employed as a physical therapist, engages in the practice of physical therapy outside the course and scope of federal employment, the person must obtain a license under this chapter.
• Teaching Classes such as weekend classes.  A physical therapist licensed in another state or credentialed to practice physical therapy in another country if the person is teaching, demonstrating, or providing physical therapy services in connection with an educational seminar. However, the exemption under this subdivision may not exceed sixty (60) days in a calendar year.
• Travel with an athletic team. A physical therapist licensed in another state or credentialed in another country if the person by contract or employment is providing physical therapy to patients affiliated with or employed by established athletic teams, athletic organizations, or performing arts companies temporarily practicing, competing, or performing in Indiana. However, the exemption under this subdivision may not exceed sixty (60) days in a calendar year.
• Assistance in declared local or national disasters. A physical therapist who is licensed in another state and who provides physical therapy during a declared local or national disaster or emergency. However, the exemption may not exceed sixty (60) days following the emergency declaration. To be eligible for the exemption, the physical therapist must notify the board of the person's intent to practice.
• Forced to leave due to local or national disaster.  A physical therapist licensed in another state who is forced to leave the person's residence or place of employment due to a declared local or national disaster or emergency and due to displacement seeks to practice physical therapy. However, the exemption may not exceed sixty (60) days following the emergency declaration. To be eligible for the exemption, the physical therapist must notify the board of the person's intent to practice.

Sharp Debridement Referral 25-27-1-3.5 

Sec. 3.5. A physical therapist may not perform sharp debridement unless the physical therapist is referred by a physician, osteopath, or podiatrist. 

Indiana Board of Physical Therapy 27-1-4 

Sec. 4 created the Indiana Board of Physical Therapy to regulate the practice of physical therapy in Indiana.

The board consists of three physical therapists, one physical therapist assistant, and one Indiana resident who is not associated with physical therapy in any way other than as a consumer. 

Beginning July 1, 2019, the governor shall make each appointment for a term of four (4) years (IC 25-1-6.5). A board member may not serve more than eight years in a ten-year period. Each physical therapist and physical therapist assistant appointed must have an unrestricted license or certificate issued under this chapter; have had not less than five years experience in the actual practice of physical therapy immediately preceding appointment, and be a resident of Indiana and actively engaged in the state in the practice of physical therapy during incumbency as a member of the board.

A majority member vote is required to take action on any measure, and the board meets at least quarterly.  

Determination of Qualifications; Administration of Examinations; Standards for Competent Practice 25-27-1-5 

• Pass upon the qualifications of physical therapists who apply for licensure and physical therapist assistants who apply for certification.

• Provide all examinations either directly or by delegation by approving and utilizing the services of a testing company or agent to prepare, conduct, and score examinations.

• Determine the applicants who successfully pass examinations.

• License and certify qualified applicants.

• Adopt rules concerning the competent practice of physical therapy to the board.

• Adopt rules establishing standards for the competent practice of physical therapy.

• Adopt rules concerning a continuing competency requirement for the renewal of a license for a physical therapist and a certificate for a physical therapist assistant.

The Indiana Board of Physical Therapy is sometimes confused with the Indiana Chapter of the APTA. They are two separate entities and have different roles in Indiana.   

As mentioned earlier, the mission of the Indiana Board is to protect the public.  The mission of the Indiana Chapter of the APTA is to maximize the lifelong health, function, and well-being of people in Indiana and advance the practice of physical therapy through advocacy, collaboration, and education.

The Indiana Board of Physical Therapy posts committee minutes and agendas, which include disciplinary actions, on their website.  These are public documents.  

Obtaining Licensure 25-27-1-6 through 25-27- 1-6.4 

In these sections, rules for obtaining a license or certificate for those educated inside and outside of the United States are included.  

Every applicant for a license as a physical therapist or certification as a physical therapist assistant must present evidence that there is no conviction for a crime that will directly affect the applicant's ability to practice competently and he or she has not had disciplinary action initiated by the licensing agency of another state or jurisdiction on the grounds that the applicant was unable to practice as a physical therapist or physical therapist assistant without endangering the public.  

The applicant has 15 days to appeal the board's decision to deny licensure or certification after the applicant receives the notification of the board's decision. An administrative hearing will be set after receiving the appeal by the board.    

An applicant for a license as a physical therapist or a certification as a physical therapist assistant must do the following: 

• Complete the application, including payment of any fees
• Submit proof of graduation from the appropriate professional education program (physical therapist or physical therapist assistant) accredited by a national accreditation agency approved by the board.  
• Pass an examination by the board
• Submit to a national criminal history background check and meet any other requirements established by the board.  

Educated Outside the United States

An applicant for a license as a physical therapist or physical therapist assistant who has been educated outside the United States must do all of the above plus the following:

• Provide satisfactory evidence that the applicant's education is substantially equivalent to the education of a physical therapist or physical therapist assistant educated in an accredited entry-level program as determined by the board by any of the following:

  • Providing evidence of graduation outside the United States from a professional education program accredited by the same accrediting agency that the board approves for programs within the United States.

  • Do the following:

    • Provide evidence of graduation from a physical therapist or physical therapist assistant education program that prepares the applicant to engage in physical therapy without restriction.

    • Provide evidence that the applicant's school is recognized by its own ministry of education.

    • Undergo a credentials evaluation as directed by the board to determine if the candidate meets uniform criteria for educational requirements established.

• Complete any additional education required by the board.
• Pass a board-approved English proficiency examination if the applicant's native language is not English.

• Complete supervised clinical practice with a restricted license if required by rule

Examination/Reexamination; Examination Security 25-27-1-7 

To sit for the examination, the applicant must meet the standards of the testing company or national organization employed to administer the examination and the requirements adopted.  The board may employ a testing company or a national organization to administer the examination within Indiana. 

The physical therapist examination must test the applicant's entry-level competence in physical therapy theory, examination and evaluation, diagnosis, prognosis, treatment intervention, prevention, and consultation.

The physical therapist assistant examination must test the applicant's requisite knowledge and skills in the technical application of physical therapy services.

An applicant for a license to practice physical therapy or for a certificate to act as a physical therapist assistant may take the respective examination not more than six times.

An applicant for licensure or certification must agree to abide by any security and copyright provisions related to the examination. If the board determines that an applicant has violated the agreement or engaged in or attempted to engage in any other conduct that subverts or undermines the integrity of the examination process or validity of examination results, the board may disqualify the applicant from taking or retaking the examination. The disqualification by the board may be permanent or for a specified period of time. A determination by the board may be appealed. The board will report any violation of security and copyright related to the examination or subversion or attempts to subvert the national examination to the Federation of State Boards of Physical Therapy. 

Issuance of license; Renewal; Reinstatement; Temporary Nonrenewable Permit; Retirement From Practice 25-27-1-8 

Issuance. The board will license a physical therapist or certify a physical therapist assistant who successfully passes the examination and is qualified as determined by the chapter.  

Renewal. Licenses or Certificates issued by the board expire on June 30 of even-numbered years specified by the Indiana professional licensing agency. A renewal fee that is set by the board must be paid biennially on or before the date determined by the Indiana professional licensing agency.  If the fee is not paid by that date, the license or certificate is automatically invalid without action by the board.  The board sets up a reinstatement fee.  

Reinstatement. An expired license or certificate can be reinstated up to three years after the original expiration date if the penalty fee (set by the board) is paid, renewal fees for the biennium are paid, and the individual demonstrated evidence of continuing competence.    

If a license or certificate has been expired for longer than three years, the holder may be reexamined by the board.  The board may adopt rules setting requirements for reinstatement of an expired license or certificate and are subject to change. Currently, those rules are on the website and include a reinstatement fee, a completed reinstatement document (which is on the website to download), a letter of work history detailing employment since your Indiana license expired, verification of any other state license held, and proof of continuing education totaling 22 hours with 2 hours in ethics and Indiana jurisprudence.  These hours must have been obtained within the last 24 months.   

Permit. The board will not issue more than two temporary permits to a physical therapist or physical therapist assistant.  A person holding a temporary permit may practice physical therapy only under the onsite supervision of a licensed physical therapist who is responsible for the patient.

The board will issue a temporary permit to any person once they pay the fee set by the board and the following have been met: 

• have a valid license to practice as a physical therapist from another state or a valid certificate from another state to practice physical therapist assistant OR
• has been approved by the board to take the examination for PT licensure or PTA certification has not failed the examination previously in any state, and has graduated from a physical therapy school or a two-year college education program for physical therapist assistants that meet the standards set by the board. The applicant must take the examination within the time limits set by the board.

A temporary permit expires when the applicant becomes licensed or certified, or approved for endorsement licensing or certification by the board, or when the application for licensure has been disapproved, whichever occurs first. An application for licensure or certification is disapproved and any temporary permit based upon the application expires when the applicant fails to take the examination within the time limits set by the board or when the board receives the notification of the applicant's failure to pass any required examination in Indiana or any other state.

Retirement. A holder of a license or certificate who wishes to retire from practice is to notify the board in writing. Upon receipt of the notice, the board will make a record that the license or certificate holder is retired and release the person from further payment of renewal fees.

If a license or certificate has been retired but the holder wishes to have it reinstated, they must submit a written request to the board. The board has the authority to establish any conditions it deems appropriate for the surrender or reinstatement of a surrendered license or certificate. Additionally, if there are any disciplinary proceedings pending against the holder of a license or certificate under this chapter, they cannot surrender their license or certificate to the board without the board's written consent.

Foreign applicants; license or certificate by endorsement; fee 25-27-1-9 

The board may register and furnish a license to or certify by endorsement any applicant who presents evidence satisfactory to the board of being duly licensed to practice physical therapy or to act as a physical therapist assistant in another state if the applicant is otherwise qualified as required in section 6 of this chapter. However, the board shall register and furnish a license or certificate by endorsement to any applicant who is licensed to practice physical therapy or to act as a physical therapist assistant in another state if:

• the applicant is qualified under sections 6
• has successfully passed a licensure examination in another state equal to or exceeding the examination standards of Indiana 
• paid a fee determined by the board

The board may license a physical therapist or certify as a physical therapist assistant any person who has graduated as a physical therapist or physical therapist assistant, whichever is appropriate, in a foreign country from an educational program approved by the board if the applicant has successfully passed the physical therapy licensure or physical therapist assistant certification examination, paid a fee determined by the board and presents satisfactory evidence to the board that the applicant :

• does not have a conviction for
  • an act that would constitute a ground for disciplinary sanction  or
  • a crime that has a direct bearing on the applicant's ability to practice competently and
  • has not been the subject of a disciplinary action initiated by the licensing agency of another state or jurisdiction on the grounds that the applicant was unable to practice as a physical therapist or physical therapist assistant without endangering the public

25-27-1-13 Physical Therapist Duties; Supervision

A physical therapist is responsible for managing all aspects of the physical therapy care of each patient. A physical therapist's role is the following: 

• Perform the initial evaluation, determination of a physical therapy diagnosis, prognosis, plan of treatment intervention, and documentation of each encounter with each patient.
• Periodic re-evaluation and documentation of each patient
• Complete the documented discharge of the patient, including the patient's response to treatment intervention at the time of discharge.
• Provide all treatment interventions for the patient that require a physical therapist's education, skills, and knowledge.
• Determine the appropriate use of physical therapist assistants for safe, effective, and efficient patient care.  
• Assure the qualifications of all physical therapist assistants and physical therapy aides under the physical therapist's direction and supervision.

Supervision. A physical therapist assistant works under a physical therapist's supervision. A physical therapist assistant documents the care that the physical therapist assistant provides.

A physical therapist may use physical therapy aides for designated tasks. A physical therapy aide works under the direct supervision of a physical therapist. Tasks related to patient services must be assigned to a physical therapy aide by a physical therapist or physical therapist assistant.

Documentation and Billing 27-1-14

A physical therapist is responsible for accurately documenting and billing for the services they provide. Similarly, a physical therapist assistant is responsible for accurately documenting and billing for the services they provide.

Physical Therapy Plan of Care 25-27-1-15