Physical Therapy Practice Act Mods.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 669

Short Title: Physical Therapy Practice Act Mods. (Public)
Sponsors: Senator Sawrey (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 26, 2025
*S669-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO AMEND THE LAWS REGULATING THE PRACTICE OF PHYSICAL 2
THERAPY. 3
The General Assembly of North Carolina enacts: 4
SECTION 1. G.S. 90-270.90 reads as rewritten: 5
"Article 18E. 6
"Physical Therapy. 7
"§ 90-270.90. Definitions. 8
In this Article, unless the context otherwise requires, the following definitions shall apply: 9
… 10
(4) "Physical therapy" means the evaluation or treatment of any person by the use 11
of physical, chemical, or other properties of heat, light, water, electricity, 12
sound, massage, or therapeutic exercise, or other rehabilitative procedures, 13
with or without assistive devices, for the purposes of preventing, correcting, 14
or alleviating a physical or mental disability. Physical therapy includes the 15
performance of specialized tests of neuromuscular function, administration of 16
specialized therapeutic procedures, interpretation and implementation of 17
referrals from licensed medical doctors or dentists, and establishment and 18
modification of physical therapy programs for patients. Ev aluation and 19
treatment of patients may involve physical measures, methods, or procedures 20
as are (i) found commensurate with physical therapy education and training 21
training, (ii) the standards of acceptable and prevailing physical therapy 22
practice, and (iii) generally or specifically authorized by regulations of the 23
Board. Physical therapy education and training shall include study of the 24
skeletal manifestations of systemic disease. Physical therapy does not include 25
the application of roentgen rays or radioactive materials, surgery, the practice 26
of chiropractic, as defined by G.S. 90-143, or medical diagnosis of disease. 27
…." 28
SECTION 2. G.S. 90-270.91 reads as rewritten: 29
"§ 90-270.91. Board of Examiners. 30
The North Carolina Board of Physical Therapy Examiners is hereby created. The Board shall 31
consist of eight members, including one medical doctor licensed and residing in North Carolina, 32
four physical therapists, two physical therapist assistants, and one public member. The public 33
member shall be appointed by the Governor and shall be a person who is not licensed under 34
Chapter 90 who shall represent the interest of the public at large. The medical doctor, physical 35
therapists, and physical therapists assistants shall be appointed by the Governor from a list 36
General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 669-First Edition
compiled by the North Carolina Physical Therapy Association, Inc., American Physical Therapy 1
Association North Carolina (APTANC), following the use of a nomination procedure made 2
available to all physical therapists and physical therapist assistants licensed and residing in North 3
Carolina. In soliciting nominations and compiling its list, the Association will give consideration 4
to geographic distribution, practice setting (institution, independent, academic, etc.), and other 5
factors that will promote representation of all aspects of physical therapy practice on the Board. 6
The records of the operation of the nomination procedure shall be filed with the Board, to be 7
available for a period of six months following nomination, for reasonable inspection by any 8
licensed practitioner. Each physical therapist member of the Board shall be licensed and reside 9
in this State; provided that the physical therapist shall have not less than three years' experience 10
as a physical therapist immediately preceding appointment and sha ll be actively engaged in the 11
practice of physical therapy in North Carolina during incumbency. Each physical therapist 12
assistant member shall be licensed and reside in this State; provided that the physical therapist 13
assistant shall have not less than thr ee years' experience as a physical therapist assistant 14
immediately preceding appointment and shall be actively engaged in practice as a physical 15
therapist assistant in North Carolina during incumbency. 16
Members shall be appointed to serve three-year terms, or until their successors are appointed, 17
to commence on January 1 in respective years. In the event that a member of the Board for any 18
reason shall become ineligible to or cannot complete a term of office, another appointment shall 19
be made by the Governor, in accordance with the procedure stated above, to fill the remainder of 20
the term. No member may shall serve for more than two successive three-year terms. 21
The Board may immediately remove a member from the Board if the member is found by the 22
remainder of the Board to have (i) ceased to meet the qualifications specified in this section, (ii) 23
failed to attend three successive Board meetings without just cause, (iii) violated any of the 24
provisions of this Article or rules adopted by the Board, or (iv) otherwi se engaged in immoral, 25
dishonorable, unprofessional, or unethical conduct. Before removing a Board member for 26
immoral, dishonorable, unprofessional, or unethical conduct, the Board shall further find that the 27
relevant conduct has compromised the integrity of the Board. 28
The Board each year shall designate one of its physical therapist members as chairman and 29
one member as secretary -treasurer. Each member of the Board shall receive such per diem 30
compensation and reimbursement for travel and subsistence as sha ll be set for licensing boards 31
generally." 32
SECTION 3. G.S. 90-270.92 reads as rewritten: 33
"§ 90-270.92. Powers of the Board. 34
The Board shall have the following general powers and duties: 35
(1) Examine and determine the qualifications and fitness of applican ts for a 36
license to practice physical therapy in this State. 37
(2) Issue, renew, deny, restrict, suspend, or revoke licenses to practice physical 38
therapy in this State, or reprimand encumber or otherwise discipline licensed 39
physical therapists and physical t herapist assistants.assistants who 40
demonstrate unprofessional conduct, including departure from, or failure to 41
conform to the standards commensurate with acceptable and prevailing 42
physical therapy practice, or the ethics of the physical therapy profession as 43
defined by the American Physical Therapy Association, Code of Ethics for 44
the Physical Therapist, and Standards of Ethical Conduct for the Physical 45
Therapist Assistant. 46
(3) Conduct confidential investigations for the purpose of determining whether 47
violations of this Article or grounds for disciplining licensed physical 48
therapists or physical therapist assistants exist. Investigation records shall not 49
be considered public records under Chapter 132 of the General Statutes. These 50
records are privileged and a re not subject to discovery, subpoena, or other 51
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Senate Bill 669-First Edition Page 3
means of legal compulsion for release to any person other than the Board or 1
its employees or consultants, except as provided in this section. However, any 2
Board decisions rendered, hearing notices and statements of charges, and any 3
material received and admitted into evidence at Board hearings shall be public 4
records, regardless of whether the notices, statements, or materials are 5
developed or compiled as a result of an investigation; provided that identifying 6
information concerning the treatment or delivery of professional services to a 7
patient who has not consented to its public disclosure may shall be deleted or 8
redacted. 9
(4) Establish mechanisms for assessing the continuing competence of licensed 10
physical therapists or physical therapist assistants to engage in the practice of 11
physical therapy, including approving rules requiring licensees to 12
periodically, or in response to complaints or incident reports, submit to the 13
Board: (i) evidence of continuing educ ation experiences; (ii) evidence of 14
minimum standard accomplishments; or (iii) evidence of compliance with 15
other Board-approved measures, audits, or evaluations; and specify remedial 16
actions if necessary or desirable to obtain license renewal or reinstatement. 17
(5) Employ such or contract professional, clerical or special personnel necessary 18
to carry out the provisions of this Article, and may purchase or rent necessary 19
office space, equipment and supplies. 20
(6) Conduct administrative hearings in accordance with Chapter 150B of the 21
General Statutes when a "contested case" as defined in G.S. 150B-2(2) arises 22
under this Article. 23
(7) Appoint from its own membership one or more members to act as 24
representatives of the Board at any meeting where such representatio n is 25
deemed desirable. 26
(8) Establish reasonable fees for applications for examination, licensure, 27
certificates of licensure and renewal, and other services provided by the 28
Board. 29
(9) Adopt, amend, or repeal any rules or regulations necessary to carry out t he 30
purposes of this Article and the duties and responsibilities of the Board. 31
(10) Request the Department of Public Safety to provide criminal history record 32
checks pursuant to G.S. 90-270.96 in connection with licensure. 33
(11) Issue subpoenas, on signature of the Board Chair or Executive Director, to 34
compel the attendance of any witness or the production of any documents 35
relative to investigations or Board proceedings. Upon written request, the 36
Board shall revoke a subpoena if, upon a hearing, it finds that the evidence 37
sought does not relate to a matter in issue, the subpoena does not describe with 38
sufficient particularity the evidence sought, or for any other reason in law the 39
subpoena is invalid. 40
(12) Establish or participate in programs for aiding in the recovery and 41
rehabilitation of physical therapists and physical therapist assistants who 42
experience chemical or alcohol addiction or abuse or mental health problems. 43
(13) Acquire, hold, rent, encumber, alienate, and otherwise deal with real property 44
in the same manner as a private person or corporation, subject only to approval 45
of the Governor and the Council of State. Collateral pledged by the Board for 46
an encumbrance is limited to the assets, income, and revenues of the Board. 47
The powers and duties enumerated above are granted for the purpose of enabling the Board 48
to safeguard the public health, safety and welfare against unqualified or incompetent practitioners 49
of physical therapy, and are to be liberally construed to accomplish this objective. In instan ces 50
where the Board makes a decision to discipline physical therapists or physical therapist assistants 51
General Assembly Of North Carolina Session 2025
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under powers set out by any of subsections subdivisions (2) through (4) and (6) of this section, it 1
may as part of its decision charge the reasonable costs of investigation and hearing to the person 2
disciplined." 3
SECTION 4. G.S. 90-270.93 reads as rewritten: 4
"§ 90-270.93. Records to be kept; copies of record. 5
The Board shall keep a record of proceedings under this Article and a record of all persons 6
licensed under it. The record shall show the name, email, last known place of business and last 7
known place of residence, and date and number of licensure certificate as a physical therapist or 8
physical therapist assistant, for every living licensee. Any interested person in the State is entitled 9
to obtain a copy of that record on application to the Board and payment of such reasonable charge 10
as may be fixed by it based on the costs involved." 11
SECTION 5. G.S. 90-270.95 reads as rewritten: 12
"§ 90-270.95. Qualifications of applicants for examination; licensure; application; fee. 13
Any person who desires to be licensed under this Article and who:who meet s all of the 14
following: 15
(1) Is of good moral character;character. 16
(2) If an applicant for physical therapy therapist licensure, has been graduated 17
from a physical therapy therapist program accredited by an agency recognized 18
by either the U.S. Office of Education or the Council on Postsecondary 19
Accreditation; andfor Higher Education Accreditation. 20
(3) If an appl icant for physical therapist assistant licensure, licensure has been 21
graduated from a physical therapist assistant educational program accredited 22
by an agency recognized by either the U.S. Office of Education or the Council 23
on Postsecondary Accreditation;for Higher Education Accreditation, then the 24
applicant may make application on a form furnished by shall apply to the 25
Board for examination for licensure as a physical therapist or physical 26
therapist assistant. At the time of making such that application, the applicant 27
shall pay to the secretary -treasurer of the Board the fee prescribed by the 28
Board, no portion of which shall be returned." 29
SECTION 6. G.S. 90-270.96(a) reads as rewritten: 30
"(a) All applicants for licensure shall consent to a criminal history record check. Refusal 31
to consent to a criminal history record check may shall constitute grounds for the Board to deny 32
licensure to an applicant. The Board shall be responsible for providing to the State Bureau of 33
Investigation the fingerprints of the applicant to be checked, a form signed by the applicant 34
consenting to the criminal history record check and the use of fingerprints and other identifying 35
information required by the State or National Repositories, and any additional information 36
required by the State Bureau of Investigation. The Board shall keep all information obtained 37
pursuant to this section confidential." 38
SECTION 7. G.S. 90-270.97 reads as rewritten: 39
"§ 90 -270.97. Licensure of foreign-trained non-CAPTE educated physical 40
therapists.therapists and physical therapist assistants. 41
Any person who has been trained as a physical therapist or physical therapist assistant in a 42
foreign country non-CAPTE educational program and desires to be licensed under this Article 43
and who:who satisfies all of the following: 44
(1) Is of good moral character;character. 45
(2) Holds a diploma Has a diploma from an educational program for physical 46
therapists or physical therapist assistants approved by the Board;Board. 47
(3) Submits documentary evidence to the Board of completion of a course of 48
instruction substantially equivalent to that obtained by an applicant for 49
licensure under G.S. 90-270.95; andG.S. 90-270.95. 50
General Assembly Of North Carolina Session 2025
Senate Bill 669-First Edition Page 5
(4) Demonstrates satisfactory proof of proficiency in the En glish 1
language;language. 2
may The person shall make application on a form furnished by to the Board for examination 3
licensure as a foreign-trainednon-CAPTE educated physical therapist or physical therapist 4
assistant. At the time of making such application, the applicant shall pay to the secretary-treasurer 5
of the Board the fee prescribed by the Board, no portion of which shall be returned." 6
SECTION 8. G.S. 90-270.98 reads as rewritten: 7
"§ 90-270.98. Certificates of licensure. 8
(a) The Board shall furnish a certificate of licensure to each applicant successfully 9
passing the examination for licensure as a physical therapist or physical therapist assistant, 10
respectively. Upon receipt of satisfactory evidence that an applicant has graduated, within six 11
months prior to application, from a physical therapy or physical therapy assistant program 12
accredited as required under G.S. 90-270.95, the Board may authorize the applican t to perform 13
as a physical therapist or physical therapist assistant in this State, but only under the immediate 14
supervision of a physical therapist licensed in this State, until a formal decision by the Board on 15
the application for license. If a new graduate applicant that has been authorized to perform under 16
supervision by a licensed physical therapist fails (without due cause as determined in the Board's 17
discretion) to take the next succeeding examination, or if the applicant fails to pass the 18
examination, and consequently does not become licensed, the authorization for the applicant to 19
perform under supervision shall expire. Applicants approved by the Board for performance as 20
physical therapists or physical therapist assistants while their applications a re pending under 21
circumstances described in this subsection shall be referred to as Physical Therapist Graduate or 22
Physical Therapist Assistant Graduate. respectively, and who satisfies the requirements of 23
G.S. 90-270.95. 24
(b) The Board shall furnish a certi ficate of licensure to any person who is a physical 25
therapist or physical therapist assistant registered or licensed under the laws of another state or 26
territory, if the individual's qualifications were at the date of his or her registration or licensure 27
substantially equal to the requirements under this Article.Article and if the individual satisfies 28
the requirements of G.S. 90-270.95. When making such application, the applicant shall pay to 29
the secretary-treasurer of the Board the fee prescribed by the Board, no portion of which shall be 30
returned." 31
SECTION 9. G.S. 90-270.99 reads as rewritten: 32
"§ 90-270.99. Renewal of license; lapse; revival. 33
(a) Every licensed physical therapist or physical therapist assistant shall, during th e 34
month of Januaryfrom November 1 through January 31 at close of business of every year, apply 35
to the Board for a renewal of licensure and pay to the secretary -treasurer the prescribed fee. If 36
January 31 is not a business day, the renewal deadline shall be the next succeeding business day. 37
Licenses that are not so renewed shall automatically lapse. The Board may decline to renew 38
licenses of physical therapists or physical therapist assistants for failure to comply with any 39
required continuing competency measures. 40
(b) The manner in which lapsed licenses shall be revived, reinstated, or extended shall be 41
established by the Board in its discretion." 42
SECTION 10. G.S. 90-270.100 reads as rewritten: 43
"§ 90-270.100. Fees. 44
The Board may collect fees established by i ts rules, but those fees shall not exceed the 45
following schedule for the specified items: 46
(1) Each application for licensure ............................................................$150.00 47
(1a) Continuing competence course approvals ..........................................$150.00 48
(2) License renewal ..................................................................................$120.00 49
(3) Transfer/verification/replace certificate ...............................................$30.00 50
(4) Examination retake...............................................................................$60.00 51
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(5) Late renewal .........................................................................................$20.00 1
(6) Licensure revival (in addition to renewal) ...........................................$30.00 2
(7) Directory ..............................................................................................$10.00 3
(8) Licensee lists or labels ...........................................................................60.00 4
In all instances where the Board uses the services of a national testing service for preparation, 5
administration, or grading of examinations, the Board may charge the applicant the actual cost 6
of the examination services, in addition to its other fees." 7
SECTION 11. G.S. 90-270.101 reads as rewritten: 8
"§ 90-270.101. Exemptions from licensure; certain practices exempted. 9
(a) The following persons shall be permitted to practice physical therapy or assist in the 10
practice in this State without obtaining a license under this Article upon the terms and conditions 11
specified herein: 12
… 13
(6) Persons authorized to perform as physical therapists or physical therapist 14
assistants under the provision of G.S. 90-270.98; 15
… 16
(10) Physical therapist or physical therapist assistant applicants s eeking licensure 17
or revival while completing the clinical practice requirements required by this 18
Article and licensees performing remediation. Completing the clini cal 19
practice requirement without a license under this subdivision and performing 20
remediation shall be performed under a Board-approved plan and supervision 21
of a licensed physical therapist. 22
…." 23
SECTION 12. G.S. 90-270.102 reads as rewritten: 24
"§ 90-270.102. Unlawful practice. 25
Except as otherwise authorized in this Article, if any person, firm, or corporation shall: 26
(1) Practice, attempt to practice, teach, consult, or supervise in physical therapy, 27
or hold out any person as being able to do any of these things in this State, 28
without first having obtained a license or authorization from the Board for the 29
person performing services or being so held out; 30
(2) Use in connection with any person's name any letters, words, numerical codes, 31
or insignia indicating or implying that the person is a physical therapist or 32
physical therapist assistant, or applicant with "Graduate" status, unless the 33
person is licensed or authorized in accordance with this Article; 34
(3) Practice or attempt to practice physical therapy with a revoked, lapsed, or 35
suspended license; 36
(4) Practice physical therapy and fail to refer to a licensed medical doctor or 37
dentist appropriate healthcare professional any patient whose medical 38
condition should have, at the time of evaluation or treatment, been determined 39
to be beyond the scope of practice of a physical therapist; 40
(5) Aid, abet, or assist any unlicensed person to practice physical therapy in 41
violation of this Article; or 42
(6) Violate any of the provisions of this Article; 43
said person, firm, or corporation shall be guilty of a Class 1 misdemeanor. Each act of such 44
unlawful practice shall constitute a distinct and separate offense." 45
SECTION 13. G.S. 90-270.103 reads as rewritten: 46
"§ 90-270.103. Grounds for disciplinary action. 47
Grounds for disciplinary action shall include but not be limited to the following: 48
(1) The employment of fraud, deceit or misrepresentation in obtaining or 49
attempting to obtain a license, or the renewal thereof;thereof. 50
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(2) The use of drugs or intoxicating liquors to an extent which affects professional 1
competency;competency. 2
(3) Conviction of an offense under any municipal, State, or federal narcotic or 3
controlled substance law, until proof of rehabilitation can be 4
established;established. 5
(4) Conviction Subject to G.S. 93B-8.1, conviction of a felony or other public 6
offense involving moral turpitude, until proof of rehabilitation can be 7
established;or a misdemeanor. 8
(5) An adjudication of insanity or incompetency, until proof of recovery from the 9
condition can be established;established. 10
(6) Engaging in any act or practice violative of any of the provisions of this Article 11
or of any of the rules and regulations adopted by the Board, or aiding, abetting 12
or assisting any other person in the violation of the same;same. 13
(7) The commission of an act or acts of malpractice, gross negligence or 14
incompetence in the practice of physical therapy;therapy. 15
(8) Practice as a licensed physical therapist or physical therapist assistant without 16
a valid certificate of renewal;renewal. 17
(9) Engaging in conduct that could result in harm or injury to the public. 18
(10) Violation of recognized standards of ethics of the physical therapy profession 19
established under the rules adopted by the Board." 20
SECTION 14. The North Carolina Board of Physical Therapy Examiners may adopt 21
rules to implement this act. 22
SECTION 15. This act becomes effective October 1, 2025. 23