Physical Therapist and Physical Therapist Assistant Frequently Asked Questions

Fees and Licensing Continuing Education License Status Supervision Intermuscular Needling Endorsement

Fees and Licensing

How much is the application fee?

The application fee depends on the application type. You can find more information on the physical therapy licensing information webpage.

See WAC 246-915-990 and WAC 246-915-99005 for details.

How long does the application process take?

See the most current application processing times on our Application Status webpage. The quickest way to check the status of your application at any time is to visit the Provider Credential Search site.

Is there a limit on how many times I can take the National Physical Therapy Exam (NPTE)?

You may take the NPTE a maximum of six times. However, you will not be allowed to test more than two times if you receive very low scores on your first two exams. A very low score is defined as performing at or below chance level (scale score four hundred and below) per WAC 246-915-030.

If I have a student-issued transcript or NPTE scores, can I send that with my application?

No. Per WAC 246-915-039, all required documentation must be sent directly from the issuing institution to:

Department of Health
Board of Physical Therapy
P.O. Box 47877
Olympia, WA 98504-7877

If I'm licensed in another state, may I begin practicing once you have my application?

No. You must have a valid Washington state physical therapy license or compact privilege before practicing as a physical therapist or physical therapist assistant. RCW 18.74.010: Definitions. (wa.gov)

You may consider a compact privilege as a way to practice in Washington state

How do I apply for a compact privilege?

Visit the Physical Therapy Compact website for more information on how to purchase your compact privilege.

What credential evaluation agencies does Washington state accept?

The Board of Physical Therapy recognizes only the credential evaluation services listed below. The board requires each credential evaluation service to complete the appropriate Course Work Tool (CWT) adopted by the Federation of State Boards of Physical Therapy (FSBPT). The appropriate CWT means the CWT in place at the time the foreign educated physical therapist earned their professional degree in physical therapy, per WAC 246-915-120.

Foreign Credentialing Commission on Physical Therapy, Inc. (FCCPT)
124 W. St. S., 3rd Floor
Alexandria, VA 22314-1917
703-684-8406

International Consultants of Delaware, Inc. (ICD)
3600 Market St., Ste. 450
Philadelphia, PA 19104-2651
215-222-8454, ext. 510, fax 215-349-0026

International Education Research Foundation (IERF)
P.O. Box 3665
Culver City, CA 90231-3665
310-258-9451

How much is my renewal fee?

If you renew on or before your birth date, you pay the annual fee. If you renew after your birth date, you pay the renewal and late penalty fees. Late penalty fees won’t be waived.

See WAC 246-915-990 and WAC 246-915-99005.

How long does the renewal process take?

Renewal notices are mailed six to eight weeks before your expiration date to allow enough processing time. It's important to pay immediately to ensure that your license will be delivered on or before your expiration date. It’s against the law to work without a current license and you’re required to post a copy of the license in a visible location at your worksite.

It's important to plan ahead. With more than 7,000 licensed physical therapists and 2,300 licensed physical therapist assistants in Washington state, the board isn't able to fax copies of licenses or provide written verification for those who renew late.

Continuing Education

How many hours of continuing competency/continuing education am I required to report and when?

To renew a physical therapist license, every two years you must complete:

32 hours of continuing education (CE)
200 employment hours involving the application of physical therapy knowledge and skills

To renew a physical therapist assistant license, every two years you must complete:

24 hours of CE
200 employment hours involving the application of physical therapy knowledge and skills

You must complete this requirement by your birthdate every two years. The CE and employment hours must have been obtained during the preceding two years, from birthdate to birthdate. If you're reporting this year, any CE that was obtained before your birth date two years ago or after your current birthdate, cannot be used to satisfy the CE or employment requirement. The expiration date for all credentials is your birthdate.

Effective January 1, 2024, you are required to complete two hours of health equity CE every two years. These two hours may be counted towards your CE requirements. Free training options and other information can be found on our Health Equity Continuing Education webpage.

A full list of activities that can be counted towards CE requirements and 200 employment hours can be found under WAC 246-915-085.

Does the board pre-approve continuing education courses?

The board does not pre-approve continuing education courses for presenters or licensees. Licensed physical therapists and physical therapist assistants may only report continuing education courses that are specifically related to the practice of physical therapy. Verify that your activity is appropriate by reviewing the documentation requirements corresponding with each option listed in WAC 246-915-085.

May I get an extension of time to complete my continuing education?

Extensions may be granted for emergency situations only. It's not advisable to wait until the continuing education (CE) is due to request the extension. If you have exhausted all possibilities for fulfilling your continuing competency requirements and are contemplating requesting an extension, keep in mind that:

requests can take six weeks or longer. If your license is set to expire before your request can be considered, you can't practice without a current license.
if your request is denied, you'll still have to complete the CE hours and 200 employment hours prior to your expiration date.
if an extension is granted, you must complete all past due requirements in addition to the CE and employment hours required for your license type for the next renewal cycle. See above for requirements.
the board grants extensions of time to complete continuing competency requirements only for extenuating circumstances.
Examples of circumstances the board does not consider to be extenuating are:
- employer no longer pays for CE/limited personal funds.
- childcare/pregnancy.
- living outside the United States.
- course was cancelled - not enough time to find another.
- working in a state that doesn't require CE.
- recently divorced.

What happens if I'm audited?

The board audits a percentage of all currently licensed physical therapists and licensed physical therapist assistants to ensure compliance with the continuing competency requirements. If audited, you'll be required to provide:

Certificates of completion for each CE course. If the following information is not contained in the certificate of completion, you must also provide:
- information describing the course sponsors
- the goals and objectives of the course
- the credentials of the presenter as a recognized authority on the subject presented
- dates of attendance
- total hours for all CE courses being reported
A one-page synopsis (in 12-point font) for each hour of reading time for books or articles reviewed. The time spent writing a synopsis is not reportable
A one-page synopsis (in 12-point font) for each hour of running time for live or recorded instructional electronic media
Outline of presentation materials, date, and location of presentation for preparation in the event the PT is preparing and presenting professional physical therapy courses or lectures
Proof of publication which may include poster presentations in the event the PT has written preparation and publication of original scholarly research or work published in a peer-review journal
A transcript verifying courses taken. One quarter credit is equal to 10 hours; one trimester credit is equal to 12 hours; and one semester credit is equal to 15 hours
Proof of 200 hours of physical therapy employment, or evidence of other non-clinical activities completed under WAC 246-915-085.

What is the process for having a verification of my Washington state physical therapy license sent to another jurisdiction?

The requesting jurisdiction may access a primary source verification letter from our online provider credential search tool. You may also submit a written request and the verification fee with a check or money order made payable to:

Department of Health
Board of Physical Therapy
P.O. Box 1099
Olympia, WA 98507-1099

License Status

Under my graduate interim permit, may I have more than one sponsoring physical therapist?

Yes. The law requires you to be directly supervised, including co-signature of notes, by a licensed physical therapist. Some interim permit holders work at more than one facility. You may be sponsored by as many supervising physical therapists as you need per WAC 246-915-078.

Can I put my license “on hold”?

You may put your license in an inactive status under WAC 246-12-090. While your license is inactive, you do not have to complete your CE and knowledge and skills hours, but once you request to return to active status, you will need to have those hours completed within the 2 years prior to your request. You may also be required to retake the National Physical Therapy Examination (NPTE), depending on how long you have your license in an inactive status. See WAC 246-915-350 for more information.

How do I reactivate my inactive license?

Under WAC 246-915-350 a physical therapist or physical therapist assistant with an inactive credential for three years or less who wishes to return to active status shall meet the requirements of chapter 246-12 WAC, Part 4.

A physical therapist or physical therapist assistant with an inactive credential for more than three years, who has been in active practice in another United States jurisdiction, and wishes to return to active status shall:

(a) Submit verification of active practice from any other United States jurisdiction; and
(b) Meet the requirements of chapter 246-12 WAC, Part 4.

A physical therapist or physical therapist assistant with an inactive credential for more than three years, but less than five years, who has not been in active practice in another United States jurisdiction, and wishes to return to active status shall:

(a) Successfully pass the NPTE as provided in RCW 18.74.035. The board may waive reexamination if the physical therapist or physical therapist assistant presents evidence of continuing competency satisfactory to the board; and
(b) Shall meet the requirements of chapter 246-12 WAC, Part 4.

A physical therapist or physical therapist assistant with an inactive credential for five years or longer, who has not been in active practice in another United States jurisdiction, and wishes to return to active status shall:

(a) Meet the requirements of chapter 246-12 WAC, Part 4; and
(b) Successfully retake and pass the NPTE as provided in RCW 18.74.035.

How do I reactive my expired license?

Under WAC 246-915-050 if the license has expired for one renewal cycle or less, the applicant shall meet the applicable requirements of chapter 246-12 WAC, Part 2.

If the license has expired for more than one renewal cycle and the applicant has been in active practice in another United States jurisdiction, the applicant shall:

(a) Submit verification of active practice from the other United States jurisdiction; and
(b) Meet the applicable requirements of chapter 246-12 WAC, Part 2.

If the license has expired for more than one renewal cycle but less than five years, and the applicant has not been in active practice in another United States jurisdiction, the applicant shall meet the applicable requirements of chapter 246-12 WAC, Part 2.

If the license has expired for five years or more, and the applicant has not been in active practice in another United States jurisdiction, the applicant shall meet applicable requirements of chapter 246-12 WAC, Part 2, and retake and pass the NPTE.

Supervision

As a physical therapist, how many assistive personnel may I supervise?

Under WAC 246-915-181 at any one time, you may supervise up to a total of three assistive personnel, who may be physical therapist assistants, other assistive personnel, or physical therapy aides. If you are supervising the maximum of three assistive personnel at any one time, no more than one of the assistive personnel may be a physical therapy aide. You have the sole discretion, based on the your clinical judgment, to determine whether to utilize assistive personnel to provide services to the patient.

If you are working in a nursing home, as defined in RCW 18.51.010, or in the public schools, as defined in RCW 28A.150.010, you may supervise a total of only two assistive personnel at any one time.

In addition to the assistive personnel authorized in WAC 246-915-181, you may supervise a total of two persons who are pursuing a course of study leading to a degree as a physical therapist or a physical therapist assistant.

What is a physical therapy aide?

A physical therapy aide is an unlicensed person who receives ongoing on-the-job training and assists a physical therapist or physical therapist assistant in providing physical therapy patient care and who does not meet the definition of a physical therapist, physical therapist assistant, or other assistive personnel. A physical therapy aide may directly assist in the implementation of therapeutic interventions. However, they may not alter or modify the plan of therapeutic interventions nor perform any procedure or task that only a physical therapist may perform under Chapter 246-915 WAC and WAC 246-915-010

Intramuscular Needling Endorsement

Updated July 11, 2024

What is intramuscular needling?

Intramuscular needling is defined under RCW 18.74.010 as follows: "Intramuscular needling," also known as "dry needling," means a skilled intervention that uses a single use, sterile filiform needle to penetrate the skin and stimulate underlying myofascial trigger points and connective and muscular tissues for the evaluation and management of neuromusculoskeletal pain and movement impairments. Intramuscular needling requires an examination and diagnosis. Intramuscular needling does not include needle retention without stimulation or the stimulation of auricular and distal points.

What are the requirements to qualify for the intramuscular needling endorsement?

The physical therapist must have at least one year of postgraduate practice experience that averages at least 36 hours a week and consists of direct patient care.
- If the didactic and in-person instruction detailed below was completed through pre-licensure coursework, you do not need one year of postgraduate practice experience.
A total of 100 hours of didactic instruction in the following areas:
- Anatomy and physiology of the musculoskeletal and neuromuscular systems;
- Anatomical basis of pain mechanisms, chronic pain, and referred pain;
- Trigger point evaluation and management;
- Universal precautions in avoiding contact with a patient's bodily fluids; and
- Preparedness and response to unexpected events including but not limited to injury to blood vessels, nerves, and organs, and psychological effects or complications.
A total of 75 hours of in-person intramuscular needling instruction in the following areas:
- Intramuscular needling technique;
- Intramuscular needling indications and contraindications;
- Documentation and informed consent for intramuscular needling;
- Management of adverse effects;
- Practical psychomotor competency; and
- Occupational safety and health administration's bloodborne pathogens protocol.
After completing the 100 hours of didactic instruction and 75 hours of in-person instruction, the physical therapist must complete a successful clinical review of a minimum of 150 hours of at least 150 individual intramuscular needling treatment sessions by a qualified provider. The physical therapist has up to 18 months to complete the successful clinical review.

Review RCW 18.74.200: Intramuscular needling—Endorsement for further details.

My CAPTE accredited physical therapy pre-licensure coursework covered the 100 hours of didactic training. Do I have to submit my transcripts again?

If you graduated from a CAPTE accredited physical therapy program, you will likely have completed all 100 hours of didactic instruction covering the required topics. Since you submitted transcripts to apply for your Washington state physical therapy license, you may not need to submit them again. If you feel you fall into this category please submit your application with all additional supporting documentation and the department will pull your transcripts from your existing record. If we are unable to access your transcripts, we will contact you.

How do I apply for the intramuscular needling endorsement?

You may access the application on our website starting July 1, 2024. Currently, we are only able to accept paper applications for the intramuscular needling endorsement. When the online application is available our website will be updated. Submit your application along with your supporting documentation and the $100 one-time fee to the address listed on the application. Only physical therapists (not physical therapy assistants) are eligible for this endorsement.

When can I start working on the intramuscular needling hours required under clinical review?

You can work through those hours once you have completed the 100 hours of didactic instruction and 75 hours of in-person instruction. The statute requires physical therapists to complete a successful clinical review of a minimum of 150 hours of at least 150 individual intramuscular needling treatment sessions under a qualified provider. You must complete this qualification after completing the didactic and in-person training and before applying for the endorsement.

Can I practice dry needling on an individual who is not a regular patient in my work setting to meet the 150 hours of at least 150 treatment session requirement?

Although it is not always recommended, you are not precluded from treating individuals that are known to you. A person does not have to be registered or necessarily paying for services to be considered a patient. Anyone you provide treatment to would need to have some kind of indication that dry needling could help them. A meaningful clinical review would not be possible for services provided to a person who had no indication for treatment. You must record and maintain chart notes which could be evaluated for the clinical review. You also need to be aware that under RCW 18.74.200, dry needling cannot be administered as a stand-alone treatment within a plan of care.

How do I find a qualified provider to supervise my training hours?

Your qualified provider must have knowledge of intramuscular needling. A qualified provider can be one of the following:

A physician licensed under chapter 18.71 RCW; an osteopathic physician licensed under chapter 18.57 RCW; a licensed naturopath under chapter 18.36A RCW; a licensed acupuncture and Eastern medicine practitioner under chapter 18.06 RCW; or a licensed advanced registered nurse practitioner under chapter 18.79 RCW;
A physical therapist credentialed to perform intramuscular needling in any branch of the United States armed forces;
A licensed physical therapist who currently holds an intramuscular needling endorsement; or
A licensed physical therapist who meets the requirements of the intramuscular needling endorsement. The draft rules language clarifies that this would include physical therapists from other jurisdictions who meet the requirements for an intramuscular needling endorsement in Washington but do not currently hold an endorsement.

What if I have been performing intramuscular needling out of state already?

Any physical therapist performing intramuscular needling in Washington state is required to hold the endorsement, regardless of prior experience. The statute details specific training and education requirements for individuals to qualify for the endorsement.

A physical therapist licensed in Washington state and trained out of state to perform intramuscular needling may qualify for the endorsement. However, they must meet all the requirements under RCW 18.74.200 including the required time frames for completing the training and education.

This means a physical therapist trained to dry needle out of state would need to complete the training and education requirements under RCW 18.74.200. This includes 150 hours of 150 treatment sessions under clinical review completed within 18 months of completing the didactic and in-person training.

What if I trained to perform intramuscular needling in the military?

The board has adopted rules that allow physical therapists licensed in Washington state and trained to perform intramuscular needling in any branch of the military to qualify for the endorsement. The rules require the physical therapist to submit evidence of their military credentials with their application.

Will I be able to delegate intramuscular needling?

No, the statute does not allow physical therapists to delegate intramuscular needling to physical therapy assistants or any other assistive personnel. You must remain in constant attendance of the patient for the entirety of the procedure.

What if my patient is also seeing an acupuncturist?

Under RCW 18.74.200 physical therapists shall make reasonable efforts to coordinate care with the acupuncturist or acupuncture and Eastern medicine practitioner to avoid duplication of services when they intend to perform intramuscular needling on a patient who is being treated by an acupuncturist or acupuncture and Eastern medicine practitioner for the same diagnosis.

Does my patient need to sign an informed consent form?

Yes. Under RCW 18.74.200 physical therapists shall have patients receiving intramuscular needling sign an informed consent form that includes the following information:

The definition of intramuscular needling as set forth in RCW 18.74.010;
A description of the risks of intramuscular needling;
A description of the benefits of intramuscular needling;
A description of the potential side effects of intramuscular needling; and
A statement clearly differentiating the procedure from the practice of acupuncture. Acupuncture shall be defined in accordance with the definition of "acupuncture and Eastern medicine" under RCW 18.06.010.

The Board of Physical Therapy, with help from our community partners, has developed an example of an informed consent form that includes all the required information. You are not required to use this example form, but feel free to copy some or all of the form for your own use. If you choose to create your own informed consent form or edit the example form, it must contain all the information listed above.