4 Colo. Code Regs. § 732-1.5

Current through Register Vol. 47, No. 22, November 25, 2024
Section 4 CCR 732-1.5 - PHYSICAL THERAPIST LICENSURE RULES
A.Supervision and/or Direction of Persons Not Licensed as a Physical Therapist

This Rule is promulgated pursuant to sections 12-20-204, 12-185-106(2)(b), and 12-285-116(1), C.R.S., to clarify supervision and/or direction provisions for persons not licensed as a physical therapist, which include a physical therapist assistant, certified nurse aide, provisional physical therapist, physical therapy aide, athletic trainer, massage therapist, student physical therapist, or student physical therapist assistant. A therapist of record must be established if physical therapy services are being provided by any of the persons not licensed as a physical therapist listed above. A physical therapist who performs an initial examination and evaluation, and develops an appropriate plan of care, shall be the therapist of record for that patient, unless that physical therapist transfers the responsibility to another licensed physical therapist, or a provisional physical therapist under supervision of a physical therapist or a student physical therapist under supervision of a clinical instructor actively licensed by the State of Colorado as a physical therapist, experienced and skilled enough to take on such responsibility through documentation in the patient records, including the transfer of the procedures and responsibilities provided in this Rule.

1. Delegation of duties is determined by the education and training of the individual being delegated responsibilities as allowed pursuant to Article 285 of Title 12, C.R.S., and these Board Rules. If a task cannot be delegated, then a physical therapist must personally attend to the task in-person and not through a patient chart review.
a. A physical therapist shall determine if the individual not licensed as a physical therapist who is being delegated responsibility has the appropriate education, training, and/or experience to perform duties as allowed by statute and/or rule.
b. A physical therapist shall rely on the individual's expertise and clinical reasoning when determining the most appropriate utilization of a person not licensed as a physical therapist to provide for the delivery of service that is safe, effective, and efficient.
c. A physical therapist must personally perform and cannot delegate to a person not licensed as a physical therapist the initial clinical contact, interpretation of referrals, initial examinations and evaluations, diagnosis and prognosis, development and modification of plans of care, determination of discharge criteria, and supervision of physical therapy services rendered to the patient/client, except for a provisional physical therapist under supervision of a physical therapist or a student physical therapist under supervision of a clinical instructor actively licensed as a physical therapist, experienced and skilled enough to take on such responsibility.
d. A physical therapist shall not delegate wound debridement to a person not licensed as a physical therapist, except to a provisional physical therapist under supervision of a physical therapist or a student physical therapist under supervision of a clinical instructor actively licensed as a physical therapist, experienced and skilled enough to take on such responsibility, but may delegate non-selective wound care to a physical therapist assistant.
2. A physical therapist is responsible for providing adequate or proper supervision and/or direction to a person not licensed as a physical therapist pursuant to section 12-285-120(1)(e), C.R.S.
a. A physical therapist may supervise up to four individuals at one time who are not physical therapists to assist in the physical therapist's clinical practice. This limit does not include student physical therapists and student physical therapist assistants supervised by a physical therapist for educational purposes.
b. A physical therapist shall regularly evaluate and observe the performance of any person under the individual's supervision and/or direction to ensure that all physical therapy services rendered meet the standard of care for delegation to be continued.
3. Pursuant to the definitions provided in Rule 1.4 , a physical therapist shall provide:
a. General supervision to a physical therapist assistant. However, pursuant to section 12-285-116(2), C.R.S., direct supervision is required if the physical therapist assistant is administering topical and aerosol medications when they are consistent within the scope of physical therapy practice and when any such medication is prescribed by a licensed health care practitioner who is authorized to prescribe such medication. A prescription or order shall be required for each such administration within a plan of care.
b. General supervision to a certified nurse aide in a home health care setting, as part of a physical therapist plan of care.
c. Direct supervision to a provisional physical therapist. In addition, the supervising physical therapist must perform records review and co-signature of notes.
d. Direct supervision to a physical therapy aide.
e. Direct supervision to an athletic trainer providing athletic training within a physical therapist plan of care.
f. Direct supervision to a massage therapist providing massage therapy within a physical therapist plan of care.
g. Immediate supervision to a student physical therapist or a student physical therapist assistant.
B.Supervision of Physical Therapist Assistants and Physical Therapy Aides

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to specify supervisory provisions required by section 12-285-116(1), C.R.S., for physical therapist assistants certified in accordance with section 12-285-204, C.R.S., and physical therapy aides. This Rule applies to all physical therapists who utilize physical therapist assistants and/or aides in their practice. The physical therapist shall establish a patient relationship with the client prior to any delegation that has been deemed as allowable and appropriate pursuant to Article 285, Title 12, C.R.S., and Board Rules.

1. Physical Therapist Assistants
a. For the purposes of these Rules, physical therapists may supervise physical therapist assistants performing physical therapy services as defined in section 12-285-104(6), C.R.S., and pursuant to Rule 1.4 and Rule 1.5 as determined by the physical therapist of record, except for interventions or services that are otherwise prohibited by law.
(1) Physical therapist assistants may perform non-selective wound care, but may not perform wound debridement.
(2) Physical therapist assistants may not perform dry needling.
(3) Physical therapist assistants may not perform joint mobilization, unless the supervising physical therapist has determined that the physical therapist assistant has the necessary degree of education, training and skill for safe patient care. Entry-level education is inadequate; additional formal continuing education (psychomotor and didactic) is required to perform joint mobilization. Thrust, high-velocity techniques are not within the scope of the physical therapist assistants' practice.
(4) Physical therapist assistants may not perform or assist a physical therapist in providing physical therapy of animals.
b. The following condition must be met before a physical therapist can utilize a physical therapist assistant: a physical therapist must be designated and recorded in the patient/client records as responsible for supervising the care and interventions provided by the physical therapist assistant. The designated physical therapist must consistently provide for the planning, evaluating, and supervising of all care rendered to the patient/client.
c. The physical therapist is responsible for the performance of all services performed by the physical therapist assistant. This responsibility requires the physical therapist to assure services are performed with a degree of care and skill appropriate to the physical therapist assistant's education and training.
d. The physical therapist assumes accountability for the acts delegated to or performed by a physical therapist assistant. Before delegating performance of physical therapy services to a physical therapist assistant working under general supervision, as defined in Rule 1.4 , the supervising physical therapist shall ensure that the physical therapist assistant is qualified by education and training to perform the physical therapy services in a safe, effective, and efficient manner.
e. A physical therapist assistant may not supervise other personnel in the provision of physical therapy services to a patient.
f. A physical therapist assistant under the general supervision, as defined in Rule 1.4 , of a physical therapist may act as a clinical instructor for a physical therapist assistant student. However, immediate supervision, as defined in Rule 1.4 , of the student physical therapist assistant by the physical therapist is required if the physical therapist assistant student is providing physical therapy services.
2. Physical Therapy Aides
a. All individuals not licensed as a physical therapist, not licensed as a provisional physical therapist, not certified as a physical therapist assistant, not authorized to practice as a student physical therapist or physical therapist assistant, and not otherwise regulated as a health care professional, shall be considered an aide for the purposes of this Rule.
b. A physical therapy aide may participate in limited designated tasks, as assigned by a physical therapist. The supervising physical therapist must participate in patient care on each date of service when a physical therapy aide is involved in care. Supervision must also occur in compliance with Rule 1.4(A) and Rule 1.5(A).
c. As to recordkeeping, a physical therapy aide may participate only in basic data recording in the medical record.
d. Wound care/debridement, dry needling, administration of medications, joint mobilization, and treatment on animals shall not be delegated to a physical therapy aide. The supervising physical therapist shall ensure that the physical therapy aide is qualified by education and training to participate in limited designated tasks as assigned by the physical therapist.
C.Authorized Practice of Physical Therapy by a Person Not Licensed In Colorado

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to clarify the following conditions under which a physical therapist not licensed in Colorado may practice for a temporary period of time pursuant to section 12-285-117(1)(e), C.R.S., which allows the practice of physical therapy in Colorado for no more than four consecutive weeks or more than once in any twelvemonth period by a physical therapist licensed, certified, or registered in another state or country when providing services in the absence of a physical therapist licensed in Colorado. This provision is not available for a person applying for a license in Colorado whose application is pending review and potential approval. Additional requirements for eligibility including the following:

1. The entity wishing to employ or engage the services of a visiting, physical therapist who is not otherwise licensed in Colorado must notify the Board at least one week prior to the start date and must document the need for employing or engaging the services of a visiting physical therapist.
2. The visiting physical therapist must possess a current and active license, certification, or registration in good standing in another state or country and provide a copy of the license, certification, or registration to the Board at least one week prior to practicing in Colorado.
3. The visiting physical therapist must have been engaged in the active, clinical practice of physical therapy for two of the last five years in order to be eligible.
D.Licensure by Examination for Physical Therapists

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to delineate the requirements for licensure by examination for physical therapists pursuant to section 12-285-110, C.R.S.

1. An applicant is required to demonstrate that they have successfully completed a physical therapy program that is either:
a. Accredited by a nationally recognized accrediting agency pursuant to Rule 1.4(C); or
b. Substantially equivalent pursuant to Rule 1.5(E).
2. If applying to take the National Physical Therapy Examination (NPTE), an applicant:
a. Must have successfully completed a physical therapy program or be eligible to graduate within ninety days of a program pursuant to section (1) of this Rule; and
b. Must apply through the Federation of State Boards of Physical Therapy (FSBPT).
3. An applicant for licensure by examination must graduate from a physical therapy program pursuant to section (1) of this Rule and pass the NPTE within the two years immediately preceding the date of the application.
4. An applicant who is unable to meet the requirements under section (3) of this Rule may request to demonstrate competency by any other means. The Board shall consider such a request on a case-by-case basis. The decision to approve such a request shall be at the sole discretion of the Board. In considering whether to approve such a request, the Board shall consider public safety, the particular circumstances and hardships faced by the applicant, and such other factors as the Board deems appropriate. If the Board grants a license under this section (4), the Board may subject said license to such lawful conditions as the Board finds are necessary to protect the public.
5. An applicant must submit fingerprints for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the Colorado Bureau of Investigation, which is responsible for retaining the state's criminal records set forth in section 24-60-3702(3)(B), C.R.S.
E.Licensing of Foreign-Trained Physical Therapist Graduates of Non-Accredited Programs

The purpose of this Rule is to establish procedures for determining whether a foreign-trained physical therapist applicant who has graduated from a non-accredited program has substantially equivalent education and training as required pursuant to section 12-285-113(1)(a), C.R.S.

1. A foreign-trained applicant who has graduated from a non-accredited program must have education and training in physical therapy substantially equivalent to the entry-level education and training required at accredited physical therapy programs in the United States in effect at the time of the applicant's graduation. This includes an assessment of the applicant's general and professional education, as well as training in wound care and debridement.
2. Applicants who wish to have their general and professional education considered "substantially equivalent" in order to take the National Physical Therapy Examination (NPTE) through Colorado and qualify for licensure shall submit their credentials to the Foreign Credentialing Commission of Physical Therapy (FCCPT). The applicant must submit a credentials evaluation utilizing the version of the Coursework Evaluation Tool for Foreign-Educated Physical Therapists developed by the Federation of State Boards of Physical Therapy (FSBPT) that applies to the applicant's year of graduation in order to evaluate the applicant's credentials against the requirements at accredited physical therapy programs in place at the time of the applicant's graduation. The Board will not accept a credentials evaluation from an organization not listed in this Rule.
3. A foreign-trained applicant who has graduated from a non-accredited program and already passed the NPTE may submit a credentials evaluation from a credentialing agency other than FCCPT provided that:
a. The credentialing agency utilized the version of the Coursework Evaluation Tool for Foreign-Educated Physical Therapists developed by FSBPT that applies to the applicant's year of graduation in order to evaluate the applicant's credentials against the requirements at accredited physical therapy programs in place at the time of the applicant's graduation, and
b. The applicant has been licensed in good standing and actively engaged in clinical practice as a licensed physical therapist in the United States for two out of the five years immediately preceding their application for licensure.
4. All expenses associated with the credential evaluation are the responsibility of the applicant.
5. Failure to have a credentials evaluation pursuant to the terms of this Rule will result in the Board denying the application.
6. In the event a foreign-trained applicant's general education is found to be deficient, the applicant may take and pass subject examinations from the College-Level Examination Program (CLEP) to overcome the deficiency in general education.
7. In the event a foreign-trained applicant's professional education is found to be deficient, the applicant shall either:
a. Successfully complete a Board-approved plan to overcome deficiencies; or
b. Overcome the deficiency by obtaining a master or doctorate degree at an accredited physical therapy program.
8. Degrees obtained in a transitional program are not equivalent to a professional entry-level physical therapy degree and will not be accepted for initial licensure.
9. An applicant must submit fingerprints for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the Colorado Bureau of Investigation, which is responsible for retaining the state's criminal records set forth in section 24-60-3702(3)(B), C.R.S.
F.Licensure by Endorsement for Physical Therapists

This Rule is promulgated pursuant to sections 12-20-202(3), 12-20-204, and 12-285-106(2)(b), C.R.S., to delineate the requirements for licensure by endorsement for physical therapists pursuant to the Occupational Credential Portability Program under sections 12-20-202(3) and 12-285-112, C.R.S.

1. The Board may decline to issue a license to an applicant for licensure by endorsement pursuant to the Occupational Credential Portability Program if the Board demonstrates by a preponderance of evidence, after notice and opportunity for a hearing, that the applicant:
a. Lacks the requisite substantially equivalent education, experience, or credentials to practice physical therapy; or
b. Has committed an act that would be grounds for disciplinary action under the law governing the practice of physical therapy.
2. In accordance with section 12-20-202(3)(d), C.R.S., the Board has established the following criteria for determining whether an applicant possesses experience and credentials that are substantially equivalent to section 12-285-110, C.R.S. An applicant who possesses a current and unrestricted license, in good standing, to practice physical therapy under the laws of another jurisdiction may apply for licensure by endorsement.

All of the following factors must be attested to at the time of application for Colorado licensure by endorsement in order for the applicant to establish that their experience and credentials are substantially equivalent to the requirements of section 12-285-110, C.R.S.:

a. The applicant has graduated from an accredited physical therapy program or graduated from a physical therapy program that the Board has determined to be substantially equivalent;
b. The applicant has passed the National Physical Therapy Examination (NPTE);
c. The applicant must attest that they:
(1) Have reported to the Board any injunction entered against the individual and any injunctive action pending against the individual on any license.
(2) Have reported any malpractice judgment, settlement, or claim, and any pending action or claim.
(3) Have reported any pending complaint, investigation, or disciplinary proceeding before the licensing, grievance, or disciplinary Board of any jurisdiction in which a license, registration or certification to practice physical therapy is held and where the complaint, investigation, or proceeding concerns the practice of physical therapy.
(4) Have reported any applicable felony conviction(s).
(5) Have reported to the Board any prior disciplinary action by another jurisdiction
(6) Have not committed any other acts that would be grounds for disciplinary action under section 12-285-120, C.R.S.
3. Applicants for endorsement must submit verification from each jurisdiction, federal agency, or military service branch in or through which applicant has even been licensed, registered, certified, or enrolled. Applicants must submit proof that the applicant has held for at least one year a current and valid license, certification, registration, or enrollment under a jurisdiction with a scope of practice that is substantially similar to the scope of practice of physical therapy as specified in section 12-285-101, et. seq., C.R.S. The verification can be retrieved by the applicant from the jurisdiction's or agency's website as long as the following information is included and can be verified if necessary:
a. Date license was originally issued;
b. Date of license expiration, if applicable; and
c. Disciplinary history, if applicable.

If the complete information is not available from the jurisdiction's or agency's website then the Verification of License Form must be completed by the jurisdiction or agency.

4. An applicant must submit fingerprints for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the Colorado Bureau of Investigation, which is responsible for retaining the state's criminal records set forth in section 24-60-3702(3)(B), C.R.S.
G.Reinstatement or Reactivation of an Expired or Inactive Physical Therapist License

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to establish the qualifications and procedures for applicants seeking reinstatement of an expired physical therapist license or reactivation of an inactive physical therapist license pursuant to sections 12-20-202, 12-285-114 and 12-285-115, C.R.S.

1. An applicant seeking reinstatement or reactivation of a physical therapist license shall complete a reinstatement or reactivation application and pay a fee as established by the Director.
2. If the license has been expired or inactive for two years or less, then applicant must attest to one of the following:
a. Completing continuing professional competency pursuant to section 12-285-119, C.R.S., and Rule 1.5 for the two years immediately preceding the date the application is received; or
b. Passing the National Physical Therapy Examination (NPTE) within two years before the date of application.
3. If the license has been expired or inactive for more than two years, then an applicant must demonstrate "competency to practice" pursuant to section 12-20-202(2)(c)(II)(A) -(E), C.R.S. An applicant may also request to demonstrate competency by any other means pursuant to section 12-20-202(2)(c)(II)(F), C.R.S. The Board shall consider such a request on a case-by-case basis. The decision to approve such a request shall be at the sole discretion of the Board. In considering whether to approve such a request, the Board shall consider public safety, the particular circumstances and hardships faced by the applicant, and such other factors as the Board deems appropriate. If the Board grants a license under this paragraph, the Board may subject said license to such lawful conditions as the Board finds are necessary to protect the public.
4. An applicant for reinstatement or reactivation who has actively practiced in Colorado on an expired or inactive license in violation of section 12-285-109, C.R.S., is subject to denial of application, disciplinary action, and/or other penalties as authorized in the Physical Therapy Practice Act at section 12-285-101, et seq., C.R.S., and in accordance with section 12-20-202, et seq., C.R.S.
H.Use of Titles Restricted

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to clarify the use of titles and educational degrees pursuant to section 12-285-107, C.R.S.

1. Obtaining a physical therapy license does not automatically entitle or confer upon the licensee the right to use the title "Dr." or "Doctor".
2. A licensed physical therapist can use the title "Doctor" or "Dr." only when such licensee has, in fact, been awarded a physical therapy doctorate degree (D.P.T.), or another academic or clinical doctorate degree (e.g., Ph.D., Sc.D.) from an accredited program by a nationally recognized accrediting agency as required pursuant to section 6-1-707, C.R.S., pertaining to the use of titles and degrees.
3. A physical therapist holding a doctorate degree may include the title "Doctor" or "Dr." only when accompanied by the words of the conferred degree following his/her legal name and after the title "P.T.", for example: "Dr. Jane/John Doe, P.T., D.P.T." or "Dr. Jane/John Doe, P.T., Ph.D."
4. A physical therapist not holding a physical therapy doctorate or transitional doctorate degree may not use the title D.P.T.
I.Requirements for Physical Therapists to Perform Physical Therapy of Animals

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to implement the requirements of sections 12-285-106(2)(b)(II) and 12-285-116(4), C.R.S., regarding the authority of physical therapists to treat animals.

1. A physical therapist must have the knowledge, skill, ability, and documented competency to perform an act that is within the scope of practice for physical therapists.
2. The Division of Professions and Occupations shall maintain a data base of all physical therapists that are qualified pursuant to this Rule to practice physical therapy of animals in this state.
3. All physical therapists that choose to practice physical therapy of animals shall provide the Board with such therapist's name, current address, education, and qualifications to perform physical therapy of animals for inclusion in the data base referenced in section (2) of this Rule. Information in the data base shall be open to public inspection at all times. Forms for physical therapists to provide such information shall be provided by the Board.
4. A physical therapist that desires to perform physical therapy of animals must comply with the following educational requirements:
a. Minimum of eighty contact hours over and above entry-level human physical therapy program course work for non-human animals, to include:
(1) FOUNDATION/CLINICAL SCIENCES
(a) Gross and applied non-human animal anatomy/physiology;
(b) Wound healing and response of tissues to disuse and remobilization in the non-human animal;
(c) Animal behavior;
(d) Animal restraint; and
(e) Zoonotic and infectious diseases.
(2) EXAMINATION/EVALUATION/PROGNOSIS/PT DIAGNOSIS
(a) Medical and surgical management of orthopedic, neurological, critically injured, geriatric, arthritic, and obese non-human animals; and
(b) Gait and other movement analyses.
(3) INTERVENTION/PLAN OF CARE/OUTCOME
(a) Therapeutic exercise applied to non-human animals;
(b) Therapeutic modalities; and
(c) Outcome assessment and documentation.
(4) CLINICAL EXPERIENCE
(a) Documented successful completion of a minimum of 120 hours under the supervision of a licensed physical therapist listed in the data base maintained by the Division of Professions and Occupations to perform physical therapy of animals or a licensed veterinarian.
5. Prior to performing physical therapy of an animal, the physical therapist shall obtain veterinary medical clearance of the animal by a Colorado-licensed veterinarian and must document such clearance in the animal patient's record.
6. Veterinary medical clearance means:
a. The veterinarian has previously examined the animal patient and has provided a differential diagnosis, if appropriate; and
b. The veterinarian has cleared the animal for physical therapy.
7. It is expected that the physical therapist and the veterinarian will continue professional collaboration as necessary for the well-being of the animal patient.
8. Once veterinary medical clearance has been received; the physical therapist is responsible for developing the plan of care for the animal patient's physical therapy.
9. The animal patient's record must include the verbal or written veterinary medical clearance. If verbal clearance is received, the physical therapist must document the verbal clearance in the animal patient's record, including the name of the veterinarian, date, and time clearance was received.
10. Complaints against physical therapists alleging a violation related to animal physical therapy will be forwarded to the State Board of Veterinary Medicine for its review and advisory recommendation to the State Physical Therapy Board. The State Physical Therapy Board retains the final authority by statute for decisions related to discipline of any physical therapist.
J.Requirements for Physical Therapists to Perform Dry Needling

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to establish requirements for a physical therapist to perform dry needling in accordance with section 12-285-116(5), C.R.S.

1. Dry needling is a physical intervention that uses a filiform needle to stimulate trigger points, diagnose and treat neuromuscular pain and functional movement deficits; is based upon Western medical concepts; requires an examination and diagnosis; and treats specific anatomic structures selected according to physical signs.
2. The performance of dry needling in accordance with this Rule is not the performance of acupuncture as defined in section 12-200-103, C.R.S., and is not a violation of section 12-200-108, C.R.S.
3. In order to perform dry needling, a physical therapist must have the knowledge, skill, ability, and documented competency to perform dry needling.
4. To be deemed competent to perform dry needling, a physical therapist must successfully complete a formalized course of study provided by a qualified licensed healthcare provider that:
a. Includes a minimum of fifty hours of education of which forty hours must be in-person education. The education may be broken up into more than one part. A physical therapist is permitted the limited practice of dry needling once the physical therapist has completed thirty hours, as long as such practice is confined to the scope of the education already successfully completed. All parts of this education must be successfully completed within four years.
b. Includes specific knowledge and psychomotor objectives;
c. Includes clinical decision-making;
d. Includes written and psychomotor assessment of knowledge and skills.
5. The formalized course of study set forth in section (4) of this Rule may be completed during the physical therapist's entry level education. To apply this education to the requirements in section (4) of this Rule, the remaining parts of the education must be successfully completed within four years of the date of original licensure.
6. If the physical therapist has not completed at least fifty hours of dry needling training within four years, then the licensee must stop performing dry needling at any level until the licensee has completed at least fifty hours.
7. A physical therapist who meets the requirements set forth in section (4) of this Rule must maintain documentation regarding the successful completion of these requirements and shall provide the documentation upon request by the Board.
8. Dry needling in areas where there is a risk of pneumothorax or where neurovascular compromise could be life-threatening, shall be included after the licensee has been formally educated and has had the opportunity to practice in lower risk areas.
9. Physical therapists performing dry needling in their practice must have written informed consent signed by each patient for whom dry needling is provided. A copy of the signed consent form shall be available to the patient upon request. The written informed consent must include risks and benefits of dry needling, including the risk of pneumothorax, neurovascular compromise, and infection.
10. When dry needling is performed, documentation must include a description of the technique, tissues treated, and post treatment assessment.
11. Dry needling shall not be delegated and must be directly performed by a qualified, physical therapist including needle removal and post treatment assessment.
12. Dry needling must be performed in a manner consistent with generally accepted standards of practice, including clean needle technique, use of gloves, and safe needle and biohazardous waste disposal.
13. Physical therapists who were qualified to perform dry needling under previous versions of this Rule remain qualified as of the effective date of this Rule.
K.Inactive License Status for Physical Therapists

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to outline the conditions and procedures governing inactive licensure status pursuant to section 12-285-115, C.R.S.

1. A physical therapist with an inactive license must not engage in any act or conduct that constitutes the practice of physical therapy while the physical therapist's license is inactive.
2. A physical therapist with an inactive license is exempt from the professional liability insurance requirements of section 12-285-118, C.R.S.
3. A physical therapist with an inactive license is exempt from the continuing professional competency requirements of section 12-285-119, C.R.S., and Rule 1.5(L).
4. A physical therapist may apply for reactivation of an inactive license by successfully meeting the requirements of Rule 1.5(G).
L.Continuing Professional Competency Requirements for Licensure Renewal

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to establish a continuing professional competency program pursuant to section 12-285-119, C.R.S., wherein a physical therapist shall maintain and demonstrate continuing professional competency in order to renew a license to practice physical therapy in the state of Colorado.

Furthermore, pursuant to section 12-285-119(2), C.R.S., records of assessment or other documentation developed or submitted in connection with the continuing professional competency program are confidential and not subject to inspection by the public or discovery in connection with a civil action against a physical therapist. A person or the Board shall not use the records or documents unless used by the Board to determine whether a physical therapist is maintaining continuing professional competency to engage in the profession.

1. Definitions
a. Continuing Professional Competency: The ongoing ability of a physical therapist to learn, integrate, and apply the knowledge, skills, and judgment to practice as a physical therapist according to generally accepted standards and professional ethical standards.
b. Continuing Professional Development (CPD): The Board program through which a licensee can satisfy the continuing professional competency requirements in order to renew, reinstate, or reactivate a license.
c. Deemed Status: A method to satisfy continuing professional competency requirements. A licensee who satisfies the continuing professional competency requirements of a Colorado state agency or department, an accrediting body recognized by the Board, or an entity approved by the Board pursuant to section 12-285-119(1)(c), C.R.S., may qualify under this method in lieu of completing the Board's CPD program.
d. Learning Plan: A Board approved form on which a licensee documents their goals and plans of learning that were developed from the licensee's Self-Assessment Tool (SAT). The plan can be amended/updated as needed during the renewal period.
e. Military Exemption: A method to satisfy continuing professional competency requirements. A licensee who has been approved for this exemption will not be required to meet continuing professional competency requirements during the renewal period in which they were approved by the Division of Professions and Occupations.
f. Professional Development Activities (PDA): learning activities undertaken to increase the licensee's knowledge and skill or hone existing knowledge and skill for the purpose of continuing professional development.
g. Self-Assessment Tool (SAT): a practice tool in which a licensee can reflect upon a licensee's knowledge and skills pertaining to the foundational areas of physical therapy practice taking into account the licensee's current level and area of practice.
2. Continuing Professional Competency Requirements
a. Effective after the 2020 license renewal, or upon the completion of the first renewal of a license thereafter, the licensee shall demonstrate continuing professional competency in order to renew a license by:
(1) Participation in the Continuing Professional Development (CPD) program;
(2) Completion of the requirements for deemed status as defined in sections (1)(c) and (4) of this Rule; or
(3) Completion of the requirements for Military Exemption as defined in sections (1)(e) and (5) of this Rule.
b. A licensee shall attest at the time of the renewal of a license to their compliance with continuing professional competency requirements.
3. Continuing Professional Development Program
a. The Continuing Professional Development (CPD) program entails the following:
(1) The licensee shall complete the Self-Assessment Tool (SAT) once per two-year renewal period. A licensee shall use the Board approved form.
(2) The licensee shall complete the Learning Plan once per two-year renewal period using the Board approved form.
(3) Accrual of thirty hours of Professional Development Activities (PDA) per two-year renewal period.
b. Professional Development Activities (PDA)
(1) Professional Development Activities (PDA) must be relevant to the licensee's practice as a physical therapist and pertinent to the licensee's Learning Plan. The Board will not pre-approve specific courses or providers. The licensee shall determine which activities and topics will meet their Learning Plan, and select an appropriate provider.
(2) One contact hour equals one credit hour of Professional Development Activities (PDA).
(3) Professional Development Activities List. Activities are organized into the following two categories:
(a) Educational Coursework, Fellowships, or Residencies; or
(b) Other Professional Development Activities:
(i) Formalized Assessments;
(ii) Presentations, Research, and Publications;
(iii) Mentoring or Supervision;
(iv) Independent or Group Study or In-Service; and
(v) Volunteer Service.
(4) Hours will be accepted if the activity is included in the Board's Professional Development Activities List. The Board may accept or reject activities submitted for consideration that are not identified on its list.
(5) Professional Development Activities will only apply for one two-year renewal period.
(6) A minimum of twenty of the thirty required hours must be in the Educational Coursework, Fellowships, or Residencies category.
b. Audit of Compliance. The following documentation is required for an audit of compliance of a licensee's Continuing Professional Development:
(1) The Learning Plan that is signed and executed which contains the licensee's goals in the form and manner as approved by the Board.
(2) Documentation of thirty hours of Professional Development Activities in compliance with the State Physical Therapy Board's Professional Development Activities List for documentation requirements for PDAs.
4. Deemed Status. The following criteria must be met in order to claim this status:
a. In order to renew a license, a licensee shall attest to their Deemed Status.
b. To qualify, the licensee must be in full compliance with the requirements of the state agency or department during the entire two-year renewal period of the physical therapist's license and on track to successfully complete that program or have successfully completed it.
c. Licensees claiming Deemed Status are subject to an audit of compliance. To satisfy an audit of compliance, the licensee shall submit appropriate evidence of participation in a qualifying program through submission of:
(1) Proof from the Colorado state agency or department or contractual entity verifying that the licensee is in compliance with its continuing professional competency program; and
(2) A letter from the licensee's employer certifying dates of employment for the entire two-year license renewal period, without any break; or
(3) Other documentation approved by the Board which reflects the licensee's compliance with a program of continuing professional competency.
5. Military Exemption. Pursuant to section 12-20-302, C.R.S., licensees who have been called to federally funded active duty for more than 120 days for the purpose of serving in a war, emergency, or contingency may request an exemption from the continuing professional competency requirements for the renewal, reinstatement, or reactivation of a license for the two-year renewal period that falls within the period of service or within six months following the completion of service.
a. Military exemptions must be approved by the Division of Professions and Occupations. Licensees seeking a military exemption shall submit a request in writing with evidence that the licensee's military service meets the criteria established in section 12-20-302, C.R.S.
b. After being granted a military exemption, in order to complete the renewal process, a licensee shall attest to their military exemption.
6. Records Retention. A licensee shall retain documentation demonstrating their compliance for two complete two-year renewal periods.
7. Non-Compliance. Falsifying an attestation or other documentation regarding the licensee's compliance with continuing professional competency requirements constitutes the falsification of information in an application and may be grounds for discipline pursuant to sections 12-285-120(1)(k) and (r), C.R.S.
8. Reinstatement and Reactivation. A licensee seeking to reinstate or reactivate a license which has been expired or inactivated for two years or less shall meet the competency requirements outlined in Rule 1.5(G)(2).
M.Provisional Physical Therapist License

This Rule is promulgated pursuant to sections 12-20-204 and 12-285-106(2)(b), C.R.S., to establish the qualifications and procedures for applicants seeking a provisional license to practice as a physical therapist pursuant to section 12-285-111, C.R.S. Refer to Rule 1.5 for applicable supervision requirements.

1. If the individual passes the NPTE after the license was issued, then the provisional license will expire no later than the 120 days after the date it was issued, or a regular license to practice as a physical therapist is issued to the licensee.
2. A provisional physical therapist shall purchase and maintain professional liability insurance, or be insured under a supervising physical therapist, for the amounts specified in section 12-285-118(1), C.R.S., unless the provisional physical therapist is exempted pursuant to section 12-285-118(3), C.R.S.

4 CCR 732-1.5

43 CR 22, November 25, 2020, effective 12/15/2020
44 CR 10, May 25, 2021, effective 6/14/2021
44 CR 18, September 25, 2021, effective 10/15/2021
45 CR 15, August 10, 2022, effective 6/28/2022
45 CR 17, September 10, 2022, effective 9/30/2022
45 CR 22, November 25, 2022, effective 12/15/2022