New93 role standards, now public
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Role standards

Therapy and rehabilitation

Physical therapist

What a newly licensed physical therapist must be able to do without supervision: examine, reach a movement diagnosis, decide who is safe to treat today and who needs another clinician, and run a plan of care that others can carry out. Drawn from the licensure examination every US jurisdiction uses to make that decision.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
4
Sources
3
Version
1

Built from Federation of State Boards of Physical Therapy, American Physical Therapy Association. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent physical therapist does on day one, dimension by dimension.

Clinical skills

  • Chooses examination tests and standardised outcome measures that answer the question in front of them, performs them safely, and interprets the results against norms, cut-offs and the patient's own goals.
  • Prescribes exercise with a stated dose matched to the impairment and the patient's response, and progresses or regresses it on explicit criteria while respecting precautions.

Workflow and tools

  • Turns examination findings into a plan of care with measurable, time-bound functional goals, a justified frequency and duration, and discharge criteria, and revises it when progress stalls.
  • Documents examination, evaluation, plan and each session so that another therapist could continue care and a reviewer could verify what was done and why it needed a therapist.

Patient communication

  • Teaches the patient and their carers what the problem is, what the plan is and how to do the home programme safely, and confirms it landed by having them explain and show it.
  • Finds out, in the patient's own words, what they need and want to be able to do, and builds the goals around that rather than around the therapist's defaults.

Compliance and safety

  • Screens for signs of medical instability or a problem outside physical therapy before and during every session, and stops, holds or refers with the right urgency when they find one.
  • Identifies fall risk with a validated measure and a review of contributing factors, and puts in place the guarding, equipment and plan that reduce it.

Role knowledge

  • Forms and tests competing hypotheses from the history and examination, reaches a movement diagnosis, recognises when the findings do not fit a movement problem, and decides whether to treat, treat and refer, or refer.
  • Directs physical therapist assistants and aides only within their legal scope and competence, stays responsible for the plan, and supervises at the level state law and the payer require.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Records or reports a test result, outcome measure score or functional level, such as independent on stairs, that they did not actually test that day.

    Discharge, equipment and supervision decisions are made on that finding, and a patient sent home on an ability nobody saw is a fall waiting to happen. It is also a false record.

  • Proceeds with exercise or mobilisation, or sends the patient away with a routine plan, when there are signs of medical instability or a red flag - such as abnormal resting vital signs with new breathlessness or chest symptoms, signs of a clot, or saddle numbness with bladder change - instead of stopping and getting the right clinician with the right urgency.

    Exercising a patient with a pulmonary embolism, an ischaemic heart or cauda equina compression turns a treatable emergency into a death or a permanent disability.

  • Plans or continues visits to use up authorised visits or to meet a clinic target rather than because the patient needs skilled therapy, or writes progress the patient has not made to keep them authorised.

    Billing for therapy that is not needed, or reporting progress that did not happen, is fraud against the payer and the patient, and it delays the referral or change the patient actually needs.

  • Keeps treating a presentation as a musculoskeletal problem when the findings point to a non-musculoskeletal or serious cause - pain that movement does not change, pain brought on by exertion, night pain with weight loss, or a progressing neurological deficit - without referring the patient to a physician.

    Under direct access the therapist may be the only clinician the patient sees, and weeks of treatment for a shoulder that is really angina or a back that is really a tumour is weeks of the disease going untreated.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not prescribe or adjust medication, or order imaging or laboratory tests, unless their state law and facility privileges expressly allow it.Refers to the physician or prescriber with a clear account of the findings and what they are concerned about.
  • Does not delegate examination, evaluation, diagnosis, prognosis, writing or changing the plan of care, re-examination or discharge to a physical therapist assistant or an aide.Performs these themselves, and directs the PTA to carry out interventions within the plan with stated parameters.
  • Does not diagnose medical disease or tell a patient they have one.Names the movement diagnosis they can make, explains honestly why they are referring, and hands the concern to a physician with the right urgency.
  • Does not treat by direct access beyond the conditions their state sets, such as a time or visit limit before physician involvement, or bill a payer that requires a physician-certified plan without one.Knows their state's direct-access rules and the payer's plan-of-care certification requirement, and involves the physician when either requires it.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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