Physical Therapy Practice Act Mods.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025

SESSION LAW 2026-16
HOUSE BILL 536

*H536-v-4*
AN ACT TO AMEND THE LAWS REGULATING THE PRACTICE OF PHYSICAL
THERAPY.

The General Assembly of North Carolina enacts:

SECTION 1. G.S. 90-270.90 reads as rewritten:
"Article 18E.
"Physical Therapy.
"§ 90-270.90. Definitions.
In this Article, unless the context otherwise requires, the following definitions shall apply:
…
(4) "Physical therapy" means the evaluation or treatment of any person by the use
of physical, chemical, or other properties of heat, light, water, electricity,
sound, massage, or therape utic exercise, or other rehabilitative procedures,
with or without assistive devices, for the purposes of preventing, correcting,
or alleviating a physical or mental disability. Physical therapy includes the
performance of specialized tests of neuromuscular function, administration of
specialized therapeutic procedures, interpretation and implementation of
referrals from licensed medical doctors or dentists, and establishment and
modification of physical therapy programs for patients. Evaluation and
treatment of patients may involve physical measures, methods, or procedures
as are (i) found commensurate with physical therapy education and training
training, (ii) the standards of acceptable and prevailing physical therapy
practice, and (iii) generally or spec ifically authorized by regulations of the
Board. Physical therapy education and training shall include study of the
skeletal manifestations of systemic disease. Physical therapy does not include
the application of roentgen rays or radioactive materials, surgery, the practice
of chiropractic, as defined by G.S. 90-143, or medical diagnosis of disease.
…."
SECTION 2. G.S. 90-270.91 reads as rewritten:
"§ 90-270.91. Board of Examiners.
The North Carolina Board of Physical Therapy Examiners is hereby created. The Board shall
consist of eight members, including one medical doctor licensed and residing in North Carolina,
four physical therapists, two physical therapist assistants, and one public member. The public
member shall be appointed by the Governor and sh all be a person who is not licensed under
Chapter 90 who shall represent the interest of the public at large. The medical doctor, physical
therapists, and physical therapists assistants shall be appointed by the Governor from a list
compiled by the North Carolina Physical Therapy Association, Inc., American Physical Therapy
Association North Carolina (APTANC), following the use of a nomination procedure made
available to all physical therapists and physical therapist assistants licensed and residing in North
Carolina. In soliciting nominations and compiling its list, the Association will give consideration
to geographic distribution, practice setting (institution, independent, academic, etc.), and other

Page 2 Session Law 2026-16 House Bill 536
factors that will promote representation of all aspects of physical therapy practice on the Board.
The records of the operation of the nomination procedure shall be filed with the Board, to be
available for a period of six months following nomination, for reasonable inspection by any
licensed practitioner. Each physical therapist member of the Board shall be licensed and reside
in this State; provided that the physical therapist shall have not less than three years' experience
as a physical therapist immediately preceding appointment and shall be actively engaged in the
practice of physical therapy in North Carolina during incumbency. Each physical therapist
assistant member shall be licensed and reside in this State; provided that the physical therapist
assistant shall have not less than three years' experience as a physical therapist assistant
immediately preceding appointment and shall be actively engaged in pract ice as a physical
therapist assistant in North Carolina during incumbency.
Members shall be appointed to serve three-year terms, or until their successors are appointed,
to commence on January 1 in respective years. In the event that a member of the Board for any
reason shall become ineligible to or cannot complete a term of office, another appointment shall
be made by the Governor, in accordance with the procedure stated above, to fill the remainder of
the term. No member may shall serve for more than two successive three-year terms.
The Board may immediately remove a member from the Board if the member is found by the
remainder of the Board to have (i) ceased to meet the qualifications specified in this section, (ii)
failed to attend three successive Board meetings without just cause, (iii) violated any of the
provisions of this Article or rules adopted by the Board, or (iv) otherwise engaged in immoral,
dishonorable, unprofessional, or unethical conduct. Before removing a Board member for
immoral, dishonorable, unprofessional, or unethical conduct, the Board shall further find that the
relevant conduct has compromised the integrity of the Board.
The Board each year shall designate one of its physical therapist members as chairman and
one member as secretary -treasurer. Each member of the Board shall receive such per diem
compensation and reimbursement for travel and subsistence as shall be set for licensing boards
generally."
SECTION 3. G.S. 90-270.92 reads as rewritten:
"§ 90-270.92. Powers of the Board.
The Board shall have the following general powers and duties:
(1) Examine and determine the qualifications and fitness of applicants for a
license to practice physical therapy in this State.
(2) Issue, renew, deny, restrict, suspend, or revoke licenses to p ractice physical
therapy in this State, or reprimand encumber or otherwise discipline licensed
physical therapists and physical therapist assistants.assistants who
demonstrate unprofessional conduct, including departure from, or failure to
conform to the s tandards commensurate with acceptable and prevailing
physical therapy practice, or recognized standards of ethics of the phy sical
therapy profession as may be established by rule.
(3) Conduct confidential investigations for the purpose of determining whether
violations of this Article or grounds for disciplining licensed physical
therapists or physical therapist assistants exist. Investigation records shall not
be considered public records under Chapter 132 of the General Statutes. These
records are privileged and are not subject to discovery, subpoena, or other
means of legal compulsion for release to any person other than the Board or
its employees or consultants, except as provided in this section. However, any
Board decisions rendered, hearing notices and statements of charges, and any
material received and admitted into evidence at Board hearings shall be public
records, regardless of whether the notices, statements, or materials are
developed or compiled as a result of an investigation; provided that identifying
information concerning the treatment or delivery of professional services to a

House Bill 536 Session Law 2026-16 Page 3
patient who has not consented to its public disclosure may shall be deleted or
redacted.
(4) Establish mechanisms for assessing the continuing competence of licensed
physical therapists or physical therapist assistants to engage in the practice of
physical therapy, including approving rules requiring licensees to
periodically, or in response to co mplaints or incident reports, submit to the
Board: (i) evidence of continuing education experiences; (ii) evidence of
minimum standard accomplishments; or (iii) evidence of compliance with
other Board-approved measures, audits, or evaluations; and specify remedial
actions if necessary or desirable to obtain license renewal or reinstatement.
(5) Employ such or contract professional, clerical or special personnel necessary
to carry out the provisions of this Article, and may purchase or rent necessary
office space, equipment and supplies.
(6) Conduct administrative hearings in accordance with Chapter 150B of the
General Statutes when a "contested case" as defined in G.S. 150B-2(2) arises
under this Article.
(7) Appoint from its own membership one or more membe rs to act as
representatives of the Board at any meeting where such representation is
deemed desirable.
(8) Establish reasonable fees for applications for examination, licensure,
certificates of licensure and renewal, and other services provided by the
Board.
(9) Adopt, amend, or repeal any rules or regulations necessary to carry out the
purposes of this Article and the duties and responsibilities of the Board.
(10) Request the Department of Public Safety to provide criminal history record
checks pursuant to G.S. 90-270.96 in connection with licensure.
(11) Issue subpoenas, on signature of the Board Chair or Executive Director, to
compel the attendance of any witness or the production of any documents
relative to investigations or Board proceedings. Upon wri tten request, the
Board shall revoke a subpoena if, upon a hearing, it finds that the evidence
sought does not relate to a matter in issue, the subpoena does not describe with
sufficient particularity the evidence sought, or for any other reason in law the
subpoena is invalid.
(12) Establish or participate in programs for aiding in the recovery and
rehabilitation of physical therapists and physical therapist assistants who
experience chemical or alcohol addiction or abuse or mental health problems.
(13) Acquire, hold, rent, encumber, alienate, and otherwise deal with real property
in the same manner as a private person or corporation, subject only to approval
of the Governor and the Council of State. Collateral pledged by the Board for
an encumbrance is limited to the assets, income, and revenues of the Board.
The powers and duties enumerated above are granted for the purpose of enabling the Board
to safeguard the public health, safety and welfare against unqualified or incompetent practitioners
of physical therapy, and are to be liberally construed to accomplish this objective. In instances
where the Board makes a decision to discipline physical therapists or physical therapist assistants
under powers set out by any of subsections subdivisions (2) through (4) and (6) of this section, it
may as part of its decision charge the reasonable costs of investigation and hearing to the person
disciplined."
SECTION 4. G.S. 90-270.93 reads as rewritten:
"§ 90-270.93. Records to be kept; copies of record.
The Board shall keep a record of proceedings under this Article and a record of all persons
licensed under it. The record shall show the name, email, last known place of business and last

Page 4 Session Law 2026-16 House Bill 536
known place of residence, and date and number of licensure certificate as a physical therapist or
physical therapist assistant, for every living licensee. Any interested person in the State is entitled
to obtain a copy of that record on application to the Board and payment of such reasonable charge
as may be fixed by it based on the costs involved."
SECTION 5. G.S. 90-270.95 reads as rewritten:
"§ 90-270.95. Qualifications of applicants for examination; licensure; application; fee.
Any person who desires to be licensed under this Article and who:who meet s all of the
following:
(1) Is of good moral character;character.
(2) If an applicant for physical therapy therapist licensure, has been graduated
from a physical therapy therapist program accredited by an agency recognized
by either the U.S. Office of Education or the Council on Postsecondary
Accreditation; andfor Higher Education Accreditation.
(3) If an applicant for physical therapist assistant licensure, licensure has been
graduated from a physical therapist assistant educational program accredited
by an agency recognized by either the U.S. Office of Education or the Council
on Postsecondary Accreditation; may make application on a form furnished
by for Higher Education Accreditation, then the applicant shall apply to the
Board for examination for licensure as a physical therapist or physical
therapist assistant. At the time of making such that application, the applicant
shall pay to the secretary -treasurer of the Board t he fee prescribed by the
Board, no portion of which shall be returned."
SECTION 6. G.S. 90-270.96(a) reads as rewritten:
"(a) All applicants for licensure shall consent to a criminal history record check. Refusal
to consent to a criminal history record check may shall constitute grounds for the Board to deny
licensure to an applicant. The Board shall be responsible for providing to the State Bureau of
Investigation the fingerprints of the applicant to be checked, a form signed by the applicant
consenting to the criminal history record check and the use of fingerprints and other identifying
information required by the State or National Repositories, and any additional information
required by the State Bureau of Investigation. The Board shall keep all inform ation obtained
pursuant to this section confidential."
SECTION 7. G.S. 90-270.97 reads as rewritten:
"§ 90 -270.97. Licensure of foreign-trained non-CAPTE educated physical
therapists.therapists and physical therapist assistants.
Any person who has been t rained as a physical therapist or physical therapist assistant in a
foreign country non-CAPTE educational program and desires to be licensed under this Article
and who:who satisfies all of the following:
(1) Is of good moral character;character.
(2) Holds a diploma Has a diploma from an educational program for physical
therapists or physical therapist assistants approved by the Board;Board.
(3) Submits documentary evidence to the Board of completion of a course of
instruction substantially equivalent to that obtained by an applicant for
licensure under G.S. 90-270.95; andG.S. 90-270.95.
(4) Demonstrates satisfactory proof of proficiency in the En glish
language;language.
may The person shall make application on a form furnished by to the Board for examination
licensure as a foreign-trained non-CAPTE educated physical therapist or physical therapist
assistant. At the time of making such application, the applicant shall pay to the secretary-treasurer
of the Board the fee prescribed by the Board, no portion of which shall be returned."
SECTION 8. G.S. 90-270.98 reads as rewritten:
"§ 90-270.98. Certificates of licensure.

House Bill 536 Session Law 2026-16 Page 5
(a) The Board shall furnish a certificate of licensure to each applicant successfully
passing the examination for licensure as a physical therapist or physical therapist assistant,
respectively. Upon receipt of satisfactory evidence that an applicant has gradu ated, within six
months prior to application, from a physical therapy or physical therapy assistant program
accredited as required under G.S. 90-270.95, the Board may authorize the applicant to perform
as a physical therapist or physical therapist assistan t in this State, but only under the immediate
supervision of a physical therapist licensed in this State, until a formal decision by the Board on
the application for license. If a new graduate applicant that has been authorized to perform under
supervision by a licensed physical therapist fails (without due cause as determined in the Board's
discretion) to take the next succeeding examination, or if the applicant fails to pass the
examination, and consequently does not become licensed, the authorization for the applicant to
perform under supervision shall expire. Applicants approved by the Board for performance as
physical therapists or physical therapist assistants while their applications are pending under
circumstances described in this subsection shall be referred to as Physical Therapist Graduate or
Physical Therapist Assistant Graduate. respectively, and who satisfies the requirements of
G.S. 90-270.95.
(b) The Board shall furnish a certificate of licensure to any person who is a physical
therapist or physical therapist assistant registered or licensed under the laws of another state or
territory, if the individual's qualifications were at the date of his or her registration or licensure
substantially equal to the requirements under this Article. Article and if the individual satisfies
the requirements of G.S. 90-270.95. When making such application, the applicant shall pay to
the secretary-treasurer of the Board the fee prescribed by the Board, no portion of which shall be
returned."
SECTION 9. G.S. 90-270.99 reads as rewritten:
"§ 90-270.99. Renewal of license; lapse; revival.
(a) Every licensed physical therapist or physical therapist assistant shall, during the
month of January from November 1 through January 31 at close of business of every year, apply
to the Board for a renewal of licensure and pay to the secretary -treasurer the prescribed fee. If
January 31 is not a business day, the renewal deadline shall be the next succeeding business day.
Licenses that are not so renewed shall automatically l apse. The Board may decline to renew
licenses of physical therapists or physical therapist assistants for failure to comply with any
required continuing competency measures.
(b) The manner in which lapsed licenses shall be revived, reinstated, or extended shall be
established by the Board in its discretion."
SECTION 10. G.S. 90-270.100 reads as rewritten:
"§ 90-270.100. Fees.
The Board may collect fees established by its rules, but those fees shall not exceed the
following schedule for the specified items:
(1) Each application for licensure ............................................................$150.00
(1a) Continuing competence course approvals ..........................................$150.00
(2) License renewal ..................................................................................$120.00
(3) Transfer/verification/replace certificate ...............................................$30.00
(4) Examination retake...............................................................................$60.00
(5) Late renewal .........................................................................................$20.00
(6) Licensure revival (in addition to renewal) ...........................................$30.00
(7) Directory ..............................................................................................$10.00
(8) Licensee lists or labels ...........................................................................60.00
In all instances where the Board uses the services of a national testing service for preparation,
administration, or grading of examinations, the Board may charge the app licant the actual cost
of the examination services, in addition to its other fees."
SECTION 11. G.S. 90-270.101 reads as rewritten:

Page 6 Session Law 2026-16 House Bill 536
"§ 90-270.101. Exemptions from licensure; certain practices exempted.
(a) The following persons shall be permitted to practice physical therapy or assist in the
practice in this State without obtaining a license under this Article upon the terms and conditions
specified herein:
…
(6) Persons authorized to perform as physical therapists or physical therapist
assistants under the provision of G.S. 90-270.98;
…
(10) Physical therapist or physical therapist assistant applicants s eeking licensure
or revival while completing the clinical practice requirements required by this
Article and licensees performing remediation. Completing the clini cal
practice requirement without a license under this subdivision and performing
remediation shall be performed under a Board-approved plan and supervision
of a licensed physical therapist.
…."
SECTION 12. G.S. 90-270.102 reads as rewritten:
"§ 90-270.102. Unlawful practice.
Except as otherwise authorized in this Article, if any person, firm, or corporation shall:
(1) Practice, attempt to practice, teach, consult, or supervise in physical therapy,
or hold out any person as being able to do an y of these things in this State,
without first having obtained a license or authorization from the Board for the
person performing services or being so held out;
(2) Use in connection with any person's name any letters, words, numerical codes,
or insignia indicating or implying that the person is a physical therapist or
physical therapist assistant, or applicant with "Graduate" status, unless the
person is licensed or authorized in accordance with this Article;
(3) Practice or attempt to practice physical t herapy with a revoked, lapsed, or
suspended license;
(4) Practice physical therapy and fail to refer to a licensed medical doctor or
dentist appropriate healthcare professional any patient whose medical
condition should have, at the time of evaluation or treatment, been determined
to be beyond the scope of practice of a physical therapist;
(5) Aid, abet, or assist any unlicensed person to practice physical therapy in
violation of this Article; or
(6) Violate any of the provisions of this Article;
said person, firm, or corporation shall be guilty of a Class 1 misdemeanor. Each act of such
unlawful practice shall constitute a distinct and separate offense."
SECTION 13. G.S. 90-270.103 reads as rewritten:
"§ 90-270.103. Grounds for disciplinary action.
Grounds for disciplinary action shall include but not be limited to the following:
(1) The employment of fraud, deceit or misrepresentation in obtaining or
attempting to obtain a license, or the renewal thereof;thereof.
(2) The use of drugs or intoxicating liquors to an extent which affects professional
competency;competency.
(3) Conviction of an offense under any municipal, State, or federal narcotic or
controlled substance law, until proof of rehabilitation can be
established;established.
(4) Conviction Subject to G.S. 93B-8.1, conviction of a felony or other public
offense involving moral turpitude, until proof of rehabilitation can be
established;a misdemeanor.

House Bill 536 Session Law 2026-16 Page 7
(5) An adjudication of insanity or incompetency, until proof of recovery from the
condition can be established;established.
(6) Engaging in any act or practice violative of any of the provisions of this Article
or of any of the rules and regulations adopted by the Board, or aiding, abetting
or assisting any other person in the violation of the same;same.
(7) The commission of an ac t or acts of malpractice, gross negligence or
incompetence in the practice of physical therapy;therapy.
(8) Practice as a licensed physical therapist or physical therapist assistant without
a valid certificate of renewal;renewal.
(9) Engaging in conduct that could result in harm or injury to the public.
(10) Violation of recognized standards of ethics of the physical therapy profession
established under the rules adopted by the Board."
SECTION 14. The North Carolina Board of Physical Therapy Examiners may adopt
rules to implement this act.
SECTION 15. This act becomes effective October 1, 2026.
In the General Assembly read three times and ratified this the 18th day of June, 2026.

s/ Rachel Hunt
President of the Senate

s/ Donna McDowell White
Presiding Officer of the House of Representatives

s/ Josh Stein
Governor

Approved 3:27 p.m. this 22nd day of June, 2026