GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
SESSION LAW 2026-16
HOUSE BILL 536
AN ACT to amend the laws regulating the practice of physical Therapy.
The General Assembly of North Carolina enacts:
SECTION 1. G.S. 90‑270.90 reads as rewritten:
"Article 18E.
"Physical Therapy.
"§ 90‑270.90. Definitions.
In this Article, unless the context otherwise requires, the following definitions shall apply:
…
(4) "Physical
therapy" means the evaluation or treatment of any person by the use of
physical, chemical, or other properties of heat, light, water, electricity,
sound, massage, or therapeutic exercise, or other rehabilitative procedures,
with or without assistive devices, for the purposes of preventing, correcting,
or alleviating a physical or mental disability. Physical therapy includes the
performance of specialized tests of neuromuscular function, administration of
specialized therapeutic procedures, interpretation and implementation of
referrals from licensed medical doctors or dentists, and establishment and
modification of physical therapy programs for patients. Evaluation and treatment
of patients may involve physical measures, methods, or procedures as are (i)
found commensurate with physical therapy education and training training,
(ii) the standards of acceptable and prevailing physical therapy practice, and
(iii) generally or specifically authorized by regulations of the Board.
Physical therapy education and training shall include study of the skeletal
manifestations of systemic disease. Physical therapy does not include the
application of roentgen rays or radioactive materials, surgery, the practice of
chiropractic, as defined by G.S. 90‑143, or medical diagnosis of
disease.
…."
SECTION 2. G.S. 90‑270.91 reads as rewritten:
"§ 90‑270.91. Board of Examiners.
The North Carolina Board of
Physical Therapy Examiners is hereby created. The Board shall consist of eight
members, including one medical doctor licensed and residing in North Carolina,
four physical therapists, two physical therapist assistants, and one public
member. The public member shall be appointed by the Governor and shall be a
person who is not licensed under Chapter 90 who shall represent the interest of
the public at large. The medical doctor, physical therapists, and physical
therapists assistants shall be appointed by the Governor from a list compiled
by the North Carolina Physical Therapy Association, Inc., American
Physical Therapy Association North Carolina (APTANC), following the use of
a nomination procedure made available to all physical therapists and physical
therapist assistants licensed and residing in North Carolina. In soliciting
nominations and compiling its list, the Association will give consideration to geographic
distribution, practice setting (institution, independent, academic, etc.), and
other factors that will promote representation of all aspects of physical
therapy practice on the Board. The records of the operation of the nomination
procedure shall be filed with the Board, to be available for a period of six
months following nomination, for reasonable inspection by any licensed
practitioner. Each physical therapist member of the Board shall be licensed and
reside in this State; provided that the physical therapist shall have not less
than three years' experience as a physical therapist immediately preceding
appointment and shall be actively engaged in the practice of physical therapy
in North Carolina during incumbency. Each physical therapist assistant member
shall be licensed and reside in this State; provided that the physical
therapist assistant shall have not less than three years' experience as a
physical therapist assistant immediately preceding appointment and shall be
actively engaged in practice as a physical therapist assistant in North
Carolina during incumbency.
Members shall be appointed to serve
three‑year terms, or until their successors are appointed, to commence on
January 1 in respective years. In the event that a member of the Board for any
reason shall become ineligible to or cannot complete a term of office, another
appointment shall be made by the Governor, in accordance with the procedure
stated above, to fill the remainder of the term. No member may shall serve
for more than two successive three‑year terms.
The Board may immediately remove a
member from the Board if the member is found by the remainder of the Board to
have (i) ceased to meet the qualifications specified in this section, (ii)
failed to attend three successive Board meetings without just cause,
(iii) violated any of the provisions of this Article or rules adopted by the
Board, or (iv) otherwise engaged in immoral, dishonorable, unprofessional, or
unethical conduct. Before removing a Board member for immoral, dishonorable,
unprofessional, or unethical conduct, the Board shall further find that the
relevant conduct has compromised the integrity of the Board.
The Board each year shall designate one of its physical therapist members as chairman and one member as secretary‑treasurer. Each member of the Board shall receive such per diem compensation and reimbursement for travel and subsistence as shall be set for licensing boards generally."
SECTION 3. G.S. 90‑270.92 reads as rewritten:
"§ 90‑270.92. Powers of the Board.
The Board shall have the following general powers and duties:
(1) Examine and determine the qualifications and fitness of applicants for a license to practice physical therapy in this State.
(2) Issue, renew, deny, restrict,
suspend, or revoke licenses to practice physical therapy in this State, or
reprimand encumber or otherwise discipline licensed physical
therapists and physical therapist assistants.assistants who
demonstrate unprofessional conduct, including departure from, or failure to
conform to the standards commensurate with acceptable and prevailing physical
therapy practice, or recognized standards of ethics of the physical therapy
profession as may be established by rule.
(3) Conduct confidential
investigations for the purpose of determining whether violations of this
Article or grounds for disciplining licensed physical therapists or physical
therapist assistants exist. Investigation records shall not be considered
public records under Chapter 132 of the General Statutes. These records are
privileged and are not subject to discovery, subpoena, or other means of legal
compulsion for release to any person other than the Board or its employees or
consultants, except as provided in this section. However, any Board decisions
rendered, hearing notices and statements of charges, and any material received
and admitted into evidence at Board hearings shall be public records,
regardless of whether the notices, statements, or materials are developed or
compiled as a result of an investigation; provided that identifying information
concerning the treatment or delivery of professional services to a patient who
has not consented to its public disclosure may shall be deleted
or redacted.
(4) Establish mechanisms for assessing the continuing competence of licensed physical therapists or physical therapist assistants to engage in the practice of physical therapy, including approving rules requiring licensees to periodically, or in response to complaints or incident reports, submit to the Board: (i) evidence of continuing education experiences; (ii) evidence of minimum standard accomplishments; or (iii) evidence of compliance with other Board‑approved measures, audits, or evaluations; and specify remedial actions if necessary or desirable to obtain license renewal or reinstatement.
(5) Employ such or
contract professional, clerical or special personnel necessary to carry out
the provisions of this Article, and may purchase or rent necessary office space,
equipment and supplies.
(6) Conduct administrative hearings in accordance with Chapter 150B of the General Statutes when a "contested case" as defined in G.S. 150B‑2(2) arises under this Article.
(7) Appoint from its own membership one or more members to act as representatives of the Board at any meeting where such representation is deemed desirable.
(8) Establish reasonable fees
for applications for examination, licensure, certificates of
licensure and renewal, and other services provided by the Board.
(9) Adopt, amend, or repeal any rules or regulations necessary to carry out the purposes of this Article and the duties and responsibilities of the Board.
(10) Request the Department of Public Safety to provide criminal history record checks pursuant to G.S. 90‑270.96 in connection with licensure.
(11) Issue subpoenas, on signature of the Board Chair or Executive Director, to compel the attendance of any witness or the production of any documents relative to investigations or Board proceedings. Upon written request, the Board shall revoke a subpoena if, upon a hearing, it finds that the evidence sought does not relate to a matter in issue, the subpoena does not describe with sufficient particularity the evidence sought, or for any other reason in law the subpoena is invalid.
(12) Establish or participate in programs for aiding in the recovery and rehabilitation of physical therapists and physical therapist assistants who experience chemical or alcohol addiction or abuse or mental health problems.
(13) Acquire, hold, rent, encumber, alienate, and otherwise deal with real property in the same manner as a private person or corporation, subject only to approval of the Governor and the Council of State. Collateral pledged by the Board for an encumbrance is limited to the assets, income, and revenues of the Board.
The powers and duties enumerated
above are granted for the purpose of enabling the Board to safeguard the public
health, safety and welfare against unqualified or incompetent practitioners of
physical therapy, and are to be liberally construed to accomplish this
objective. In instances where the Board makes a decision to discipline physical
therapists or physical therapist assistants under powers set out by any of subsections
subdivisions (2) through (4) and (6) of this section, it may
as part of its decision charge the reasonable costs of investigation and
hearing to the person disciplined."
SECTION 4. G.S. 90‑270.93 reads as rewritten:
"§ 90‑270.93. Records to be kept; copies of record.
The Board shall keep a record of proceedings under this Article and a record of all persons licensed under it. The record shall show the name, email, last known place of business and last known place of residence, and date and number of licensure certificate as a physical therapist or physical therapist assistant, for every living licensee. Any interested person in the State is entitled to obtain a copy of that record on application to the Board and payment of such reasonable charge as may be fixed by it based on the costs involved."
SECTION 5. G.S. 90‑270.95 reads as rewritten:
"§ 90‑270.95. Qualifications of applicants for examination;
licensure; application; fee.
Any person who desires to be
licensed under this Article and who:who meets all of the following:
(1) Is of good moral character;character.
(2) If an applicant for
physical therapy therapist licensure, has been graduated from a
physical therapy therapist program accredited by an agency
recognized by either the U.S. Office of Education or the Council on
Postsecondary Accreditation; andfor Higher Education Accreditation.
(3) If an applicant for
physical therapist assistant licensure, licensure has been graduated
from a physical therapist assistant educational program accredited by an agency
recognized by either the U.S. Office of Education or the Council on
Postsecondary Accreditation; may make application on a form furnished by for
Higher Education Accreditation, then the applicant shall apply to the Board
for examination for licensure as a physical therapist or physical
therapist assistant. At the time of making such that application,
the applicant shall pay to the secretary‑treasurer of the Board the fee
prescribed by the Board, no portion of which shall be returned."
SECTION 6. G.S. 90‑270.96(a) reads as rewritten:
"(a) All applicants for
licensure shall consent to a criminal history record check. Refusal to consent
to a criminal history record check may shall constitute grounds
for the Board to deny licensure to an applicant. The Board shall be responsible
for providing to the State Bureau of Investigation the fingerprints of the
applicant to be checked, a form signed by the applicant consenting to the
criminal history record check and the use of fingerprints and other identifying
information required by the State or National Repositories, and any additional
information required by the State Bureau of Investigation. The Board shall keep
all information obtained pursuant to this section confidential."
SECTION 7. G.S. 90‑270.97 reads as rewritten:
"§ 90‑270.97. Licensure of foreign‑trained non‑CAPTE
educated physical therapists.therapists and physical therapist
assistants.
Any person who has been trained as
a physical therapist or physical therapist assistant in a foreign country non‑CAPTE
educational program and desires to be licensed under this Article and who:who
satisfies all of the following:
(1) Is of good moral character;character.
(2) Holds a diploma Has
a diploma from an educational program for physical therapists or physical
therapist assistants approved by the Board;Board.
(3) Submits documentary
evidence to the Board of completion of a course of instruction substantially
equivalent to that obtained by an applicant for licensure under G.S. 90‑270.95;
andG.S. 90‑270.95.
(4) Demonstrates satisfactory
proof of proficiency in the English language;language.
may The person shall make
application on a form furnished by to the Board for examination
licensure as a foreign‑trained non‑CAPTE
educated physical therapist or physical therapist assistant. At the time of
making such application, the applicant shall pay to the secretary‑treasurer
of the Board the fee prescribed by the Board, no portion of which shall be
returned."
SECTION 8. G.S. 90‑270.98 reads as rewritten:
"§ 90‑270.98. Certificates of licensure.
(a) The Board shall furnish
a certificate of licensure to each applicant successfully passing the
examination for licensure as a physical therapist or physical therapist
assistant, respectively. Upon receipt of satisfactory evidence that an
applicant has graduated, within six months prior to application, from a
physical therapy or physical therapy assistant program accredited as required
under G.S. 90‑270.95, the Board may authorize the applicant to
perform as a physical therapist or physical therapist assistant in this State,
but only under the immediate supervision of a physical therapist licensed in
this State, until a formal decision by the Board on the application for
license. If a new graduate applicant that has been authorized to perform under
supervision by a licensed physical therapist fails (without due cause as
determined in the Board's discretion) to take the next succeeding examination,
or if the applicant fails to pass the examination, and consequently does not
become licensed, the authorization for the applicant to perform under
supervision shall expire. Applicants approved by the Board for performance as
physical therapists or physical therapist assistants while their applications
are pending under circumstances described in this subsection shall be referred
to as Physical Therapist Graduate or Physical Therapist Assistant Graduate.respectively,
and who satisfies the requirements of G.S. 90‑270.95.
(b) The Board shall furnish
a certificate of licensure to any person who is a physical therapist or physical
therapist assistant registered or licensed under the laws of another
state or territory, if the individual's qualifications were at the date of his or
her registration or licensure substantially equal to the requirements under
this Article. Article and if the individual satisfies the
requirements of G.S. 90‑270.95. When making such application,
the applicant shall pay to the secretary‑treasurer of the Board the fee
prescribed by the Board, no portion of which shall be returned."
SECTION 9. G.S. 90‑270.99 reads as rewritten:
"§ 90‑270.99. Renewal of license; lapse; revival.
(a) Every licensed physical
therapist or physical therapist assistant shall, during the month of January
from November 1 through January 31 at close of business of every
year, apply to the Board for a renewal of licensure and pay to the secretary‑treasurer
the prescribed fee. If January 31 is not a business day, the renewal
deadline shall be the next succeeding business day. Licenses that are not
so renewed shall automatically lapse. The Board may decline to renew licenses
of physical therapists or physical therapist assistants for failure to comply
with any required continuing competency measures.
(b) The manner in which lapsed licenses shall be revived, reinstated, or extended shall be established by the Board in its discretion."
SECTION 10. G.S. 90‑270.100 reads as rewritten:
"§ 90‑270.100. Fees.
The Board may collect fees established by its rules, but those fees shall not exceed the following schedule for the specified items:
(1)....... Each application for licensure........................................................... $150.00
(1a)..... Continuing competence course approvals......................................... $150.00
(2)....... License renewal................................................................................. $120.00
(3)....... Transfer/verification/replace certificate.............................................. $30.00
(4)....... Examination retake.............................................................................. $60.00
(5)....... Late renewal......................................................................................... $20.00
(6)....... Licensure revival (in addition to renewal)........................................... $30.00
(7)....... Directory.............................................................................................. $10.00
(8)....... Licensee lists or labels........................................................................... 60.00
In all instances where the Board
uses the services of a national testing service for preparation,
administration, or grading of examinations, the Board may charge the applicant
the actual cost of the examination services, in addition to its other fees."
SECTION 11. G.S. 90‑270.101 reads as rewritten:
"§ 90‑270.101. Exemptions from licensure; certain practices exempted.
(a) The following persons shall be permitted to practice physical therapy or assist in the practice in this State without obtaining a license under this Article upon the terms and conditions specified herein:
…
(6) Persons authorized to perform as physical
therapists or physical therapist assistants under the provision of G.S. 90‑270.98;
…
(10) Physical therapist or physical therapist assistant applicants seeking licensure or revival while completing the clinical practice requirements required by this Article and licensees performing remediation. Completing the clinical practice requirement without a license under this subdivision and performing remediation shall be performed under a Board‑approved plan and supervision of a licensed physical therapist.
…."
SECTION 12. G.S. 90‑270.102 reads as rewritten:
"§ 90‑270.102. Unlawful practice.
Except as otherwise authorized in this Article, if any person, firm, or corporation shall:
(1) Practice, attempt to practice, teach, consult, or supervise in physical therapy, or hold out any person as being able to do any of these things in this State, without first having obtained a license or authorization from the Board for the person performing services or being so held out;
(2) Use in connection with
any person's name any letters, words, numerical codes, or insignia indicating
or implying that the person is a physical therapist or physical therapist
assistant, or applicant with "Graduate" status, unless the
person is licensed or authorized in accordance with this Article;
(3) Practice or attempt to practice physical therapy with a revoked, lapsed, or suspended license;
(4) Practice physical therapy
and fail to refer to a licensed medical doctor or dentist appropriate
healthcare professional any patient whose medical condition should have, at
the time of evaluation or treatment, been determined to be beyond the scope of
practice of a physical therapist;
(5) Aid, abet, or assist any unlicensed person to practice physical therapy in violation of this Article; or
(6) Violate any of the provisions of this Article;
said person, firm, or corporation shall be guilty of a Class 1 misdemeanor. Each act of such unlawful practice shall constitute a distinct and separate offense."
SECTION 13. G.S. 90‑270.103 reads as rewritten:
"§ 90‑270.103. Grounds for disciplinary action.
Grounds for disciplinary action
shall include but not be limited to the following:
(1) The employment of fraud,
deceit or misrepresentation in obtaining or attempting to obtain a license, or
the renewal thereof;thereof.
(2) The use of drugs or
intoxicating liquors to an extent which affects professional competency;competency.
(3) Conviction of an offense
under any municipal, State, or federal narcotic or controlled substance law,
until proof of rehabilitation can be established;established.
(4) Conviction Subject
to G.S. 93B‑8.1, conviction of a felony or other public
offense involving moral turpitude, until proof of rehabilitation can be
established;a misdemeanor.
(5) An adjudication of
insanity or incompetency, until proof of recovery from the condition can be established;established.
(6) Engaging in any act or
practice violative of any of the provisions of this Article or of any of the
rules and regulations adopted by the Board, or aiding, abetting or assisting
any other person in the violation of the same;same.
(7) The commission of an act
or acts of malpractice, gross negligence or incompetence in the practice of
physical therapy;therapy.
(8) Practice as a licensed
physical therapist or physical therapist assistant without a valid certificate
of renewal;renewal.
(9) Engaging in conduct that could result in harm or injury to the public.
(10) Violation of recognized standards of ethics of the physical therapy profession established under the rules adopted by the Board."
SECTION 14. The North Carolina Board of Physical Therapy Examiners may adopt rules to implement this act.
SECTION 15. This act becomes effective October 1, 2026.
In the General Assembly read three times and ratified this the 18th day of June, 2026.
s/ Rachel Hunt
President of the Senate
s/ Donna McDowell White
Presiding Officer of the House of Representatives
s/ Josh Stein
Governor
Approved 3:27 p.m. this 22nd day of June, 2026