Chapter 448

448.56 448.56 Practice requirements.

448.56(1) (1) Written referral. Except as provided in this subsection and s. 448.52, a person may practice physical therapy only upon the written referral of a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice nurse prescriber certified under s. 441.16 (2). Written referral is not required if a physical therapist provides services in schools to children with disabilities, as defined in s. 115.76 (5), pursuant to rules promulgated by the department of public instruction; provides services as part of a home health care agency; provides services to a patient in a nursing home pursuant to the patient’s plan of care; provides services related to athletic activities, conditioning, or injury prevention; or provides services to an individual for a previously diagnosed medical condition after informing the individual’s physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice nurse prescriber certified under s. 441.16 (2) who made the diagnosis. The examining board may promulgate rules establishing additional services that are excepted from the written referral requirements of this subsection.

448.56(1m) (1m) Duty to refer.

448.56(1m)(a) (a) A physical therapist shall refer a patient to an appropriate health care practitioner if the physical therapist has reasonable cause to believe that symptoms or conditions are present that require services beyond the scope of the practice of physical therapy.

448.56(1m)(b) (b) The examining board shall promulgate rules establishing the requirements that a physical therapist must satisfy if a physician, naturopathic doctor, physician assistant, chiropractor, dentist, podiatrist, or advanced practice nurse prescriber makes a written referral under sub. (1). The purpose of the rules shall be to ensure continuity of care between the physical therapist and the health care practitioner.

448.56(2) (2) Fee splitting. No licensee or compact privilege holder may give or receive, directly or indirectly, to or from any other person any fee, commission, rebate, or other form of compensation or anything of value for sending, referring, or otherwise inducing a person to communicate with a licensee or compact privilege holder in a professional capacity, or for any professional services not actually rendered personally by the licensee or compact privilege holder or at the licensee’s or compact privilege holder’s direction.

448.56(3) (3) Billing by professional partnerships and corporations. If 2 or more physical therapists have entered into a bona fide partnership or have formed a service corporation for the practice of physical therapy, the partnership or corporation may not render a single bill for physical therapy services provided in the name of the partnership or corporation unless each physical therapist who provided services that are identified on the bill is identified on the bill as having rendered those services.

448.56(4) (4) Responsibility. A physical therapist is responsible for managing all aspects of the physical therapy care of each patient under his or her care.

448.56(5) (5) Patient records. A physical therapist shall create and maintain a patient record for every patient the physical therapist examines or treats.

448.56(6) (6) Physical therapist assistants. A physical therapist assistant may assist a physical therapist in the practice of physical therapy if the physical therapist provides direct or general supervision of the physical therapist assistant. The examining board shall promulgate rules defining “direct or general supervision” for purposes of this subsection. Nothing in this subsection interferes with delegation authority under any other provision of this chapter.

448.56(7) (7) Ordering X-rays.

448.56(7)(a) (a) A physical therapist may order X-rays to be performed by qualified persons only if the physical therapist satisfies one of the following qualifications, as further specified by the examining board by rule:

448.56(7)(a)1. 1. The physical therapist holds a clinical doctorate degree in physical therapy.

448.56(7)(a)2. 2. The physical therapist has completed a nationally recognized specialty certification program.

448.56(7)(a)3. 3. The physical therapist has completed a nationally recognized residency or fellowship certified by an organization recognized by the examining board.

448.56(7)(a)4. 4. The physical therapist has completed a formal X-ray ordering training program with demonstrated physician involvement.

448.56(7)(b) (b) When a physical therapist orders an X-ray, the physical therapist shall communicate with the patient’s primary care physician or an appropriate health care practitioner to ensure coordination of care, unless all of the following apply:

448.56(7)(b)1. 1. A radiologist has read the X-ray and not identified a significant finding.

448.56(7)(b)2. 2. The patient does not have a primary care physician.

448.56(7)(b)3. 3. The patient was not referred to the physical therapist by another health care practitioner to receive care from the physical therapist.

448.56 History History: 1993 a. 107 ss. 54, 59; 1995 a. 27 s. 9145 (1); 1997 a. 27, 164; 2001 a. 70; 2003 a. 154; 2005 a. 187; 2009 a. 149; 2011 a. 161; 2015 a. 375; 2019 a. 100; 2021 a. 130.

448.56 Cross-reference Cross-reference: See also chs. PT 6, 7, and 10, Wis. adm. code.

448.565 448.565 Complaints. The examining board shall promulgate rules establishing procedures and requirements for filing complaints against licensees and compact privilege holders and shall publicize the procedures and requirements.

448.565 History History: 2001 a. 70; 2009 a. 149; 2019 a. 100; 2021 a. 240 s. 30.

448.567 448.567 Performance audits. The examining board shall promulgate rules that require the examining board on a periodic basis to conduct performance self-audits of its activities under this subchapter.

448.567 History History: 2001 a. 70; 2009 a. 149.

448.57 448.57 Disciplinary proceedings and actions.

448.57(1) (1) Subject to the rules promulgated under s. 440.03 (1), the examining board may make investigations and conduct hearings to determine whether a violation of this subchapter or any rule promulgated under this subchapter has occurred.

448.57(2) (2) Subject to the rules promulgated under s. 440.03 (1), the examining board may reprimand a licensee or compact privilege holder or may deny, limit, suspend, or revoke a license granted under this subchapter or a compact privilege if it finds that the applicant, licensee, or compact privilege holder has done any of the following:

448.57(2)(a) (a) Made a material misstatement in an application for a license or for renewal of a license.

448.57(2)(am) (am) Interfered with an investigation or disciplinary proceeding by using threats, harassment, or intentional misrepresentation of facts.

448.57(2)(b) (b) Subject to ss. 111.321, 111.322, and 111.335, been convicted of an offense the circumstances of which substantially relate to the practice of physical therapy or assisting in the practice of physical therapy.

448.57(2)(bm) (bm) Been adjudicated mentally incompetent by a court.

448.57(2)(c) (c) Advertised in a manner that is false, deceptive, or misleading.

448.57(2)(d) (d) Advertised, practiced, or attempted to practice under another’s name.

448.57(2)(e) (e) Subject to ss. 111.321, 111.322, and 111.34, practiced or assisted in the practice of physical therapy while the applicant’s, licensee’s, or compact privilege holder’s ability to practice or assist was impaired by alcohol or other drugs.

448.57(2)(f) (f) Engaged in unprofessional or unethical conduct in violation of the code of ethics established in the rules promulgated under s. 448.527.

448.57(2)(fm) (fm) Engaged in sexual misconduct with a patient.

448.57(2)(g) (g) Engaged in conduct while practicing or assisting in the practice of physical therapy which evidences a lack of knowledge or ability to apply professional principles or skills.

448.57(2)(h) (h) Violated this subchapter or any rule promulgated under this subchapter.

448.57(3) (3) 

448.57(3)(a) (a) A licensee may voluntarily surrender his or her license to the examining board, which may refuse to accept the surrender if the examining board has received allegations of unprofessional conduct against the licensee. The examining board may negotiate stipulations in consideration for accepting the surrender of licenses.

448.57(3)(b) (b) The examining board may restore a license that has been voluntarily surrendered under par. (a) on such terms and conditions as it considers appropriate.

448.57(4) (4) The examining board shall prepare and disseminate to the public an annual report that describes final disciplinary action taken against licensees and compact privilege holders during the preceding year.

448.57(5) (5) The examining board may report final disciplinary action taken against a licensee or compact privilege holder to any national database that includes information about disciplinary action taken against health care professionals.

448.57 History History: 1993 a. 107; 2001 a. 70; 2009 a. 149; 2019 a. 100.

448.57 Cross-reference Cross-reference: See also ch. PT 7, Wis. adm. code.

448.58 448.58 Injunctive relief. If the examining board has reason to believe that any person is violating this subchapter or any rule promulgated under this subchapter, the examining board, the department, the attorney general or the district attorney of the proper county may investigate and may, in addition to any other remedies, bring an action in the name and on behalf of this state to enjoin the person from the violation.

448.58 History History: 1993 a. 107; 2009 a. 149.

448.59 448.59 Penalties. Any person who violates this subchapter or any rule promulgated under this subchapter may be fined not more than $10,000 or imprisoned for not more than 9 months or both.

448.59 History History: 1993 a. 107.

subch. IV of ch. 448 SUBCHAPTER IV

PODIATRY AFFILIATED CREDENTIALING BOARD

Subch. IV of ch. 448 Cross-reference Cross-reference: See also Pod, Wis. adm. code.

448.60 448.60 Definitions. In this subchapter:

448.60(1) (1) “Affiliated credentialing board” means the podiatry affiliated credentialing board.

448.60(2) (2) “Licensee” means a person who is licensed under this subchapter.

448.60(3) (3) “Podiatrist” means an individual possessing the degree of doctor of podiatric medicine or doctor of surgical chiropody or equivalent degree as determined by the affiliated credentialing board, and holding a license to practice podiatry or podiatric medicine and surgery granted by the affiliated credentialing board.

448.60(4) (4) “Podiatry” or “podiatric medicine and surgery” means that branch or system of the practice of medicine and surgery that involves treating the sick which is limited to conditions affecting the foot and ankle, but does not include the use of a general anesthetic unless administered by or under the direction of a person licensed to practice medicine and surgery under subch. II.

448.60(5) (5) “Unprofessional conduct” means an act or attempted act of commission or omission, as defined by the affiliated credentialing board by rule under s. 448.695 (1), or an act by a podiatrist in violation of ch. 450 or 961.

448.60 History History: 1997 a. 175 ss. 21, 22, 69; 2005 a. 334; 2009 a. 113; 2013 a. 151 s. 28.

448.61 448.61 License required. Except as provided in ss. 257.03, 440.077, and 448.62, no person may practice podiatry, designate himself or herself as a podiatrist, use or assume the title “doctor of surgical chiropody”, “doctor of podiatry”or “doctor of podiatric medicine”, or append to the person’s name the words or letters “doctor”, “Dr.”, “D.S.C.”, “D.P.M.”, “foot doctor”, “foot specialist” or any other title, letters or designation which represents or may tend to represent the person as a podiatrist unless the person is licensed under this subchapter.

448.61 History History: 1997 a. 175; 2005 a. 96; 2009 a. 42; 2021 a. 158.

448.61 Cross-reference Cross-reference: See also ch. Pod 1, Wis. adm. code.

448.62 448.62 Applicability. This subchapter does not require a license for any of the following:

448.62(1) (1) A person lawfully practicing within the scope of a license, permit, registration or certification granted by this state or the federal government.

448.62(1m) (1m) An individual who is exempt from licensure as a physician under s. 448.03 (2m).

448.62(2) (2) A person assisting a podiatrist in practice under the direct, on-premises supervision of the podiatrist.

448.62(2m) (2m) An advanced practice nurse who is certified to issue prescription orders under s. 441.16 and who is providing nonsurgical patient services as directed, supervised, and inspected by a podiatrist who has the power to direct, decide, and oversee the implementation of the patient services rendered.

448.62(3) (3) A podiatry student engaged in activities required for his or her education or training.

448.62(4) (4) A podiatrist who is licensed to practice podiatry in another state or country and is providing a consultation or demonstration with a podiatrist who is licensed under this subchapter.

448.62(5) (5) A person performing the gratuitous domestic administration of family remedies.

448.62(6) (6) A person furnishing medical assistance or first aid at the scene of an emergency.

448.62(7) (7) A physician assistant who is acting under the supervision and direction of a podiatrist, subject to s. 448.975 (2) (a) 2m., or an individual to whom the physician assistant delegates a task or order under s. 448.975 (4).

448.62 History History: 1997 a. 175; 2017 a. 227, 341; 2021 a. 23; 2021 a. 238 s. 45.

448.63 448.63 Licensure of podiatrists.

448.63(1) (1) Subject to sub. (4), the affiliated credentialing board shall grant a license as a podiatrist to a person who does all of the following:

448.63(1)(a) (a) Submits an application for the license to the department on a form provided by the department.

448.63(1)(b) (b) Pays the fee specified in s. 440.05 (1).

448.63(1)(c) (c) Subject to ss. 111.321, 111.322 and 111.335, submits evidence satisfactory to the affiliated credentialing board that the applicant does not have an arrest or conviction record.

448.63(1)(d) (d) Submits evidence satisfactory to the affiliated credentialing board of all of the following:

448.63(1)(d)1. 1. That the applicant is a graduate of a school of podiatric medicine and surgery approved by the affiliated credentialing board and possesses a diploma from such school conferring the degree of doctor of podiatric medicine, or equivalent degree as determined by the affiliated credentialing board, unless the affiliated credentialing board waives these requirements under sub. (2).

448.63(1)(d)2. 2. That the applicant has completed 2 years of postgraduate training in a program approved by the affiliated credentialing board or one year of postgraduate training in a program approved by the affiliated credentialing board if the one-year postgraduate training was completed by June 1, 2010.

448.63(1)(e) (e) Passes an examination under s. 448.64.

448.63(2) (2) The affiliated credentialing board may waive the requirement under sub. (1) (d) 1. for an applicant who establishes, to the satisfaction of the affiliated credentialing board, all of the following:

448.63(2)(a) (a) That he or she is a graduate of a podiatry school.

448.63(2)(b) (b) That he or she is licensed as a podiatrist by another licensing jurisdiction in the United States.

448.63(2)(c) (c) That the jurisdiction in which he or she is licensed required the licensee to be a graduate of a school approved by the licensing jurisdiction or of a school that the licensing jurisdiction evaluated for education equivalency.

448.63(2)(d) (d) That he or she has actively practiced podiatry, under the license issued by the other licensing jurisdiction in the United States, for at least 3 years immediately preceding the date of his or her application.