2025 · Regular session · House bill
HB4099
HB4099 replaces the prior 10-business-day limit on qualifying physical therapy without a referral with a limit of 30 consecutive calendar days.
Official caption: Relating to the treatment of a patient by a physical therapist without a referral.
Official report lists House author(s): Harris Davila, Harris, Vasut, Gervin-Hawkins, Thompson. This does not identify sponsors or amendment drafters.
Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.
Bill highlights
Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.
- HB4099 replaces the prior 10-business-day limit on qualifying physical therapy without a referral with a limit of 30 consecutive calendar days.
- The existing eligibility safeguards remain: the therapist must have at least one year of licensure, professional liability insurance at the board-required minimum, and either a qualifying physical-therapy doctorate or at least 30 hours of continuing-competence work in differential diagnosis.
- Patients must still sign the board's disclosure acknowledging that physical therapy is not a substitute for a physician's medical diagnosis, is not based on radiological imaging, cannot diagnose an illness or disease, and may not be covered by their health insurance.
- The act required the Texas Board of Physical Therapy Examiners to adopt necessary implementing rules by December 1, 2025.
What does it do?
HB4099 replaces the prior 10-business-day limit on qualifying physical therapy without a referral with a limit of 30 consecutive calendar days. It also repeals the separate 15-business-day pathway for therapists with additional credentials. A referral is still required before treatment continues beyond the new limit. These are elapsed calendar days, not 30 visits or 30 business days. Signed June 20, 2025, the law took effect September 1, 2025. Final act · History
The existing eligibility safeguards remain: the therapist must have at least one year of licensure, professional liability insurance at the board-required minimum, and either a qualifying physical-therapy doctorate or at least 30 hours of continuing-competence work in differential diagnosis. The repealed 15-day pathway had additionally required a qualifying doctorate plus a residency/fellowship or board-approved certification. Removing that separate pathway does not remove the basic qualifications for referral-free treatment. Occupations Code 453.301 · Amendment and repeal
Patients must still sign the board’s disclosure acknowledging that physical therapy is not a substitute for a physician’s medical diagnosis, is not based on radiological imaging, cannot diagnose an illness or disease, and may not be covered by their health insurance. The referral needed for longer treatment must come from a legally qualified referring practitioner acting within their licensed scope; the statutory definition includes physicians, dentists, chiropractors and podiatrists. The law does not require insurers to pay for the additional referral-free period. Retained disclosure rule · Referring-practitioner definition
The act required the Texas Board of Physical Therapy Examiners to adopt necessary implementing rules by December 1, 2025. That deadline did not postpone the September effective date. It does not otherwise rewrite the scope of physical therapy or the existing separate emergency-care and asymptomatic-assessment provisions. Sections 3–4 · Existing exceptions
What changed along the way?
The introduced bill already proposed 30 consecutive calendar days and repeal of the separate 15-business-day option. The House committee substitute corrected the deletion formatting around “business”; the introduced text already struck that word. The House-passed, Senate committee and final versions retain the same policy. The official amendment index lists no floor amendments; the committee formatting correction should not be described as a separate substantive floor change. Introduced · House substitute · Version index · Amendment index
For the full amendment record, open the official amendment index.
Official bill versions
Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.
Who could benefit—and who could bear the costs?
Patients may continue suitable treatment for a longer initial period without arranging a separate referral, and qualifying therapists gain more time to provide care. Patients still may need a referring practitioner for ongoing treatment, and coverage or out-of-pocket costs depend on their plan and services. The act does not guarantee that waiting longer for medical evaluation is appropriate for any particular condition.
The latest fiscal note anticipated no significant state or local-government fiscal impact and assumed state costs could be absorbed with existing resources. It did not calculate patient savings, insurer payments or individual clinical outcomes. May 20 fiscal note
Review boundary: This explains the statutory time limit and retained conditions, not individual treatment advice or a verification that every therapist meets the qualifications. It does not audit later board-rule compliance or a patient’s insurance contract.
Official sources
- Bill history and latest recorded action
- Bill versions, analyses and fiscal notes
- Action history and votes
- Amendment index
Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.
