Virginia Physical Therapy Practice Act: Licensure, Scope, and Renewal

The Virginia Physical Therapy Practice Act, codified at Title 54.1, Chapter 34.1 of the Code of Virginia, is the state law that decides who can practice physical therapy in Virginia, what licensed practitioners are allowed to do, and how the state disciplines those who step outside the rules. The Board of Physical Therapy, part of the Virginia Department of Health Professions, administers licensure, continuing competency, and enforcement for both physical therapists and physical therapist assistants.¹

Getting Licensed in Virginia

Virginia Code 54.1-3477 sets three baseline requirements for a physical therapist license. You must be at least 18. You must have graduated from a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE). And you must pass a Board-approved examination.² That examination is the National Physical Therapy Examination (NPTE), administered by the Federation of State Boards of Physical Therapy.³

There is no separate Virginia jurisprudence exam. The Department of Health Professions confirms the state adds no exam requirement of its own on top of the NPTE.⁴

Application fees are $140 for a physical therapist and $100 for a physical therapist assistant. The same amounts apply whether you are applying by examination or by endorsement from another state.⁵ Every applicant must also submit fingerprints for a criminal background check run through the Central Criminal Records Exchange and the FBI, and the applicant pays for it.⁶

Graduates of programs outside the United States or Canada can still qualify, but the Board must find the education acceptable. Expect a credentials evaluation by a board-approved agency and, in some cases, proof of English proficiency.²

Treating Patients Without a Referral

The default rule in Virginia is that a physical therapist treats patients only on referral from a physician, podiatrist, dentist, advanced practice registered nurse, or supervised physician assistant.⁷ Direct access is available, but it depends on your credentials.

A physical therapist who holds a Doctor of Physical Therapy (DPT) from a CAPTE-accredited program, or who has obtained a certificate of authorization under Virginia Code 54.1-3482.1, can evaluate and treat without a referral. Two conditions attach. If the patient is not seeing another provider for the same symptoms, you can proceed. If the patient is seeing another provider, you need the patient’s written consent to share health information, and you must notify that provider within 14 days of starting treatment, along with a copy of your initial evaluation.⁸

If you do not hold a DPT, you can still earn direct-access authority through the certificate of authorization. That means completing a board-recognized transitional program, or having at least three years of active post-licensure practice plus 15 contact hours of continuing education in medical screening or differential diagnosis with a passing post-course exam.⁹

What PTs, PTAs, and Support Personnel Can Do

A licensed physical therapist evaluates patients, identifies functional limitations, and builds the treatment plan. Clinical decisions must be evidence-based, and the Act does not authorize physical therapists to prescribe medication or diagnose conditions outside physical therapy.

Physical therapist assistants work under the supervision of a licensed physical therapist. They can carry out the treatment plan, run therapeutic exercises, and provide patient education. They cannot perform initial evaluations, change treatment goals, or discharge patients on their own. The supervising physical therapist is fully responsible for care delivered by anyone working under their direction.¹⁰

Support personnel are more restricted. They perform only routine assigned tasks under the direct supervision of a licensed physical therapist or assistant, and those tasks must be nondiscretionary, meaning no professional judgment is involved.¹⁰

Renewing Your License

Virginia licenses renew every two years, with renewal due by December 31 of each even-numbered year. To renew an active license, you need at least 30 contact hours of continuing education in the preceding two years and at least 320 hours of active practice in the preceding four years.¹¹ The 30-hour requirement applies to both physical therapists and assistants.¹²

Not every hour counts the same way. For physical therapists, at least 20 of the 30 hours must be Type 1: organized programs directly tied to clinical practice from a board-approved provider. The other 10 may be Type 2, which covers less formal learning. For physical therapist assistants, the split is 15 Type 1 and up to 15 Type 2. One college credit hour counts as 15 contact hours of Type 1 education.¹²

Renewal fees are $135 for a physical therapist and $70 for an assistant. Miss the deadline, and late fees run $50 and $25 on top of the renewal. You can hold an inactive license at reduced rates of $70 and $35, but an inactive license does not permit practice.⁵

Keep your paperwork. You must retain the completed Continued Competency Activity and Assessment Form and all supporting documentation for four years after renewal. If audited, you have 30 days to produce it.¹³

Coming Back from Inactive Status

If your license has gone inactive, you can return to active practice without retaking the NPTE. You pay the difference between the inactive and active renewal fees, complete the continuing competency hours you would have needed during the inactive period (capped at four years’ worth), and show 320 hours of active practice in any jurisdiction within the four years before you apply.¹⁴

If you don’t have those practice hours, you can complete a 320-hour supervised traineeship that meets the Board’s requirements instead. That is the more common route for people who have been out of clinical work for years.¹⁴

Keeping Patient Records

Physical therapists who own or are responsible for patient records must keep them for a minimum of six years after the last patient encounter. For minors, records must be kept until the child turns 18 or becomes emancipated, and never for less than six years. Records already transferred to another provider or given to the patient don’t have to be maintained separately, though federal law or contract terms may require longer retention in some situations.¹⁵

Practicing in Other States Through the Compact

Virginia belongs to the Physical Therapy Licensure Compact, which lets licensed practitioners work in other member states without applying for a full license in each one. You buy a compact privilege for each state where you want to practice.¹⁶

To qualify, your home-state license must be active and unencumbered, you must have no disciplinary actions in the past two years, and you must meet any jurisprudence requirement of the remote state where you plan to work. Virginia’s total compact fee for a physical therapist is $50.¹⁷ While working under a compact privilege, you only need to satisfy your home state’s continuing competency rules, not the remote state’s.¹⁸ Skipping a required remote-state jurisprudence exam can cost you the privilege and invite discipline, so check each state’s rules before you treat.

Discipline and License Trouble

The Board’s enforcement authority comes from Virginia Code 54.1-2400, which lets health regulatory boards investigate complaints, hold hearings, and impose sanctions. The Board can revoke, suspend, or restrict a license, order probation, issue a reprimand, or impose a monetary penalty.¹⁹

The specific grounds for discipline are listed in Virginia Code 54.1-3480: fraud or deception in obtaining a license or in practice, substance abuse that renders the practitioner unfit, intentional or negligent conduct likely to injure a patient, mental or physical incapacity, and conviction of a felony or a crime involving moral turpitude. A license restriction imposed in another state is also grounds for action in Virginia.²⁰

A case typically starts with a complaint. The Board reviews documentation, may interview witnesses, and can send the matter to a special conference committee of at least two Board members for informal handling. That committee can exonerate the practitioner, impose probation, reprimand, modify a prior order, or deny a license. Its decision becomes final after 30 days unless the practitioner requests a formal hearing in writing within that window.¹⁹

One provision is not discretionary. The Board must refuse licensure to anyone whose physical therapy license has been revoked or suspended in another jurisdiction and not reinstated.²⁰

Practicing Without a License

Practicing physical therapy without a valid license is a Class 1 misdemeanor under Virginia Code 54.1-111, carrying up to 12 months in jail, a fine of up to $2,500, or both. The same statute reaches anyone who uses a title suggesting licensure they don’t hold and anyone who aids someone else in unlicensed practice.²¹

Repeat conduct raises the stakes. A third or later conviction within a 36-month period becomes a Class 6 felony.²¹ Employers who knowingly let unlicensed people provide physical therapy services face regulatory exposure from the Board and civil liability if a patient is harmed.

1
Virginia Code Commission. Code of Virginia – Chapter 34.1 Physical Therapy
2
Virginia Code Commission. Virginia Code 54.1-3477 – Requirements for Licensure as a Physical Therapist
3
Federation of State Boards of Physical Therapy. National Exam (NPTE)
4
Virginia Department of Health Professions. Virginia Board of Physical Therapy – Exams FAQs
5
Virginia Code Commission. 18VAC112-20-27 – Fees
6
Virginia Code Commission. Virginia Code 54.1-3484 – Criminal History Background Checks
7
Virginia Code Commission. Virginia Code 54.1-3482 – Practice of Physical Therapy; Certain Experience and Referrals Required; Physical Therapist Assistants
8
Virginia Code Commission. Virginia Code 54.1-3482 – Practice of Physical Therapy
9
Virginia Code Commission. 18VAC112-20-81 – Requirements for Direct Access Certification
10
Cornell Law School. 18 Va. Admin. Code 112-20-100 – Supervisory Responsibilities
11
Virginia Code Commission. 18VAC112-20-130 – Biennial Renewal of License
12
Virginia Code Commission. 18VAC112-20-131 – Continued Competency Requirements for Renewal of an Active License
13
Virginia Department of Health Professions. Virginia Board of Physical Therapy – Continuing Education
14
Virginia Code Commission. 18VAC112-20-135 – Inactive License
15
Virginia Code Commission. 18VAC112-20-160 – Requirements for Patient Records
16
Virginia Code Commission. Virginia Code 54.1-3488 – Compact Privilege
17
PT Compact. Process and Requirements
18
PT Compact. FAQs
19
Virginia Code Commission. Virginia Code 54.1-2400 – General Powers and Duties of Health Regulatory Boards
20
Virginia Code Commission. Virginia Code 54.1-3480 – Refusal, Revocation or Suspension
21
Virginia Code Commission. Virginia Code 54.1-111 – Unlawful Acts; Civil Penalty