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AB 2497

Physical therapists.

2025-2026 Regular Session Introduced by Natasha Johnson

Expands physical therapy scope to include neuromuscular evaluation and tissue-penetration procedures (with board certification) and allows direct access without referrals, under ne

Read third time. Refused passage. (Ayes 26. Noes 19. Page 5549.).
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Bill Summary · AB 2497

Summary of AB 2497 (2025-2026) – Physical Therapists

Purpose and intent

  • This bill overhauls several provisions of the Physical Therapy Practice Act to redefine key terms, update the scope of practice, adjust supervision rules, and enhance how physical therapy services are delivered, documented, and regulated.
  • It also aims to align education and competency requirements with national standards and to formalize certain new practices (e.g., tissue penetration methods) under board regulation.

Key provisions and changes

  • Definitions and scope (Sections 2601, 2620, 2622, 2633; repeals/additions)

    • Redefines core terms:
    • “Physical therapy,” “physical therapist,” and “physical therapist assistant” are redefined for regulatory purposes.
    • Clarifies that the use of any words, abbreviations, or insignia implying physical therapy services must be provided by or under the direction of a licensed physical therapist.
    • Eliminates a prior requirement for the board to define certain doctoral degrees in related health sciences by statute and instead allows degrees in related health sciences to be specified by the board in regulation.

  • Practice and services (Section 2620; new Section 2620.6)

    • The practice of physical therapy is expanded to explicitly include:
    • Examination, evaluation, diagnosis, prognosis, and intervention related to the movement system.
    • Design and modification of interventions to alleviate impairments and functional limitations.
    • Furnishing, ordering, fabrication, and application of assistive devices and related equipment, aligned with related sections.
    • A broad set of interventions (therapeutic exercise, gait/self-care training, manual therapy, therapeutic modalities, neuromuscular reeducation, etc.).
    • Prevention, health promotion, administration, research, and referral for other services.
    • Acknowledges direct access to physical therapy without requiring referral, but preserves obligation to refer to a physician or appropriate provider when conditions exceed the PT’s scope.

  • Direct access and referrals (Section 2620.1)

    • Clarifies that patients may directly access physical therapy services without a referral.
    • Requires a physical therapist to refer patients to a physician or other licensed provider when conditions fall outside the PT’s training or scope.

  • Tissue penetration and neuromuscular evaluation (Sections 2620.5; new 2620.6)

    • Enables certain physical therapists, upon specific authorization, to perform tissue penetration using electrode needles and solid filiform needles for neuromuscular evaluation, but notes:
    • They must be certified by the board to perform tissue penetration.
    • They cannot make diagnostic or prognostic interpretations (which would violate the Medical Practice Act).
    • Establishes standards, certification procedures, and timelines for regulation, with a sunset provision contingent on promulgation of regulations.
    • Prohibits acupuncture authority under this section (still regulated separately).

  • Credentialing and supervision (Sections 2622; 2633)

    • Supervisory limit: a physical therapist may supervise up to three physical therapist assistants (raised from two).
    • Allows one aide for patient-related tasks.
    • Maintains the prohibition on misleading advertising or misrepresenting services as physical therapy unless performed by a licensed PT.
    • Sets rules for use of the “DPT” or other doctoral initials and titles, both in writing and in spoken communication, with safeguards on how titles are presented and disclosed.

  • Regulatory development and implementation (Sections 2620.4; 2620.6)

    • Requires the Physical Therapy Board to coordinate with the Department of Consumer Affairs’ Office of Professional Examination Services (OPES) to review/validate occupational analyses of PT functions.
    • If no existing occupational analysis exists, OPES must perform one.
    • By January 1, 2029, the board and OPES must assess alignment between:
    • CA-education standards (ACFPT/CA-PT education standards) and the National Physical Therapy Examination (NPTE) competencies with the occupational analyses.
    • Based on that assessment, the board must promulgate regulations identifying the scope of services within the aligned competencies and specify any additional training/education required for new competencies.

  • Revisions to repeals and related sections (Various sections)

    • Repeals Section 2620.1 and 2620.5 and replaces with updated provisions to reflect new practice patterns and regulatory oversight.
    • Repeals and readds related sections to reflect updated terminology and scope.

Who is affected

  • Licensed physical therapists (PTs) and physical therapy assistants (PTAs) practicing in California.
  • The Physical Therapy Board of California (the regulatory agency) and the California Department of Consumer Affairs (via OPES) for licensure examinations and competency analyses.
  • Individuals seeking direct access to PT services (potentially increasing access without referral, subject to scope limits).
  • Patients receiving physical therapy, particularly those whose care involves movement-system evaluations, neuromuscular assessment, tissue penetration procedures, or advanced modalities.
  • Entities advertising physical therapy services and health care providers who refer or coordinate with PTs.

Procedural and timeline aspects

  • The bill directs regulatory development:
    • The board must obtain/contract OPES to review/validate occupational analyses and assess alignment with CA education standards and NPTE.
    • The board and OPES must complete the assessment by January 1, 2029.
    • After completion, the board must promulgate regulations to define (a) the scope of services within aligned competencies and (b) any additional training/education required for expanded competencies.
  • The tissue-penetration provisions become operative upon the operative date of the new regulations issued under Section 2620.4.
  • The bill includes standard fiscal note language indicating no required local reimbursements for mandated changes, as local costs would arise only if new crimes/infractions or penalties are created or modified.

Practical impact

  • Expanded scope of practice for PTs, including neuromuscular evaluation and certain tissue-penetration techniques (with certification and regulatory safeguards).
  • Higher supervision capacity for PTAs (up to three per PT) and allowance for one aide per PT.
  • Direct access to PT services without mandatory referrals, improving patient access (while maintaining safety via referrals when needed).
  • Shift toward regulation-driven alignment between education standards, licensure exams, and actual practice competencies, with a formal regulatory framework to define new competencies and required training by 2029.

Compiled from official sources — confirm details with the bill’s official record.

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