If you’re wondering what the PTLC is and what is a compact state, you’re not alone. Both are recent developments in telemedicine that will allow physical therapists and practices to deliver care across state lines. Telemedicine is no longer just about accessing a physician via a mobile app. It’s also about improving the delivery of care for millions of patients and hundreds of medical specialties. In this blog, we explore how the PTLC and compact states will do just that, expanding the delivery of care through new technology to improve the lives of many.
Sixteen States Are Now Part of the PTLC
When physical therapists can be part of a care team that delivers healthcare to patients at home, despite geographic boundaries, healthcare delivery improves, and more positive outcomes follow. That is the point of the Physical Therapy Licensing Compact (PTLC). The PTLC, also known as the PT Compact, is “an agreement between member states to improve access to physical therapy services for the public by increasing the mobility of eligible physical therapy providers to work in multiple states.”
As of this writing, 16 states have enacted legislation joining the Physical Therapy Compact Commission, the governing body that will implement the compact itself. None of the states have started issuing privileges yet, so physical therapists cannot yet practice in different states or participate in telemedicine services that deliver care across state lines. However, the legislation has been passed, and that is the most critical first step. As of this writing, the compact states are:
- New York
- New Jersey
- North Carolina
- North Dakota
- Washington state
What Is a Compact State?
A compact state is a state that has passed legislation allowing it to become part of the PT Compact. The Physical Therapy board in each state selects a delegate to the PT Compact Commission. The Commission is empowered by the member states to be the governing body of the compact. A compact state allows its physical therapists to offer the following benefits to patients across geographic borders:
- Continuity of care
- Portability of providers for military spouses who may frequently move across states
- Improved access to physical therapy providers
- Increased choice of physical therapy providers
- Availability of alternative delivery methods like telehealth that delivers PT services to patients in their homes
- Improved delivery of care and the removal of barriers to access caused by transportation, limited providers in rural areas, and other socio-economic factors
Currently, states fall into one of four categories regarding the PT Compact. They are:
- PT Compact member state issuing compact privileges: None yet
- Enacted PT Compact legislation but not yet issuing compact privileges: 16 states to date (see list above)
- PT Compact legislation introduced: seven states
- South Carolina
- Non-member states without legislation introduced: 27 states (see below)
Which States Are Not Part of the Compact?
Unfortunately, the states that have not signed onto the compact outnumber the states that have. The states who are not part of the compact are:
- Rhode Island
- New York
- West Virginia
- South Dakota
- New Mexico
- Puerto Rico
- Washington, D.C. and the U.S. Virgin Islands
What Is a Compact State License?
It’s called a Compact State Privilege, and it can be purchased through the PT Compact website. It allows physical therapists practicing in compact states to provide physical therapy services across state lines via telemedicine. The ability to delivery PT services into a patient’s home via telemedicine can potentially improve outcomes by improving the continuity of care and removing obstacles to follow up care. The Compact is still developing Compact Privileges, and they are not yet available. However, the Compact estimates that they will be available by mid-2018.
PT Compact lists the following information regarding obtaining Compact Privileges:
“Purchasing a Compact Privilege reduces paperwork, costs, streamlines requirements and processes and provides the ability to work in another Compact member state almost immediately.”
To purchase and maintain a Compact Privilege an individual must meet each of the following requirements:
- Hold a current, valid PT or PTA license in your home state of residence
- Your home state must be a member of the PT Compact
- You cannot have any active encumbrances or any disciplinary action against your license for a two-year period
- The state where you are seeking a compact privilege must be a member of the PT Compact
According to the Compact, “The fee to purchase Compact Privilege varies from state to state. There will be a Commission fee and a state fee. Fees will be established before the issuance of the first Compact Privileges in the first half of 2018”. The fee schedule has not yet been published.
The PT Compact is proof that a growing number of specialties see the powerful applications of telemedicine to improve the delivery of healthcare, reduce costs, and improve access. State policymakers have taken action to express their support of the technology to improve the health and well-being of their citizens through the Compact. In addition, 38 states have passed parity laws, guaranteeing that Medicare and Medicaid reimburse the delivery of care via telemedicine for their recipients. They all approve the delivery of care via live video, the same vehicle that will be used by physical therapists in Compact states. These are encouraging signs of progress toward the full-scale adoption of telemedicine in many specialties and by many organizations across the country. Let the building begin.