AN ACT to amend and reenact subsection 14 of section 43-26.1-01 and section 43-26.1-11.1 of the North Dakota Century Code, relating to diagnostic imaging by physical therapists.
SB 2273 expands the scope of physical therapy practice in North Dakota to expressly include ordering musculoskeletal diagnostic imaging, specifically plain film radiographs, and using those results to help determine whether a referral to another provider is needed or whether treatment falls within the physical therapist’s scope of practice. The bill amends the definition of the “practice of physical therapy” to add this authority and clarifies that the imaging must be performed by an authorized provider and interpreted by a physician trained in radiology interpretation.
The bill also sets qualifications for physical therapists who may order this imaging. A physical therapist must either hold a clinical doctorate in physical therapy or complete a board-approved formal medical imaging training program. In addition, the therapist must report imaging results to the patient’s designated primary care or specialty provider within seven days of receiving the image, unless the patient has no such provider or the provider already received the images from the imaging professional.
SB 2273 changes North Dakota Century Code sections 43-26.1-01 and 43-26.1-11.1 by broadening the statutory definition of physical therapy and creating a specific authorization for qualified physical therapists to order plain film radiographs for musculoskeletal concerns. The bill affects physical therapists, radiology providers, physicians, and patients by formalizing a direct-access imaging pathway while preserving coordination-of-care requirements and limiting the authority to therapists with advanced education or approved training.
The bill appears to have been broadly supported and noncontroversial. It passed the Senate unanimously, 45-0, and the House overwhelmingly, 88-1, indicating strong bipartisan agreement that the change is a modest, practical expansion of physical therapist practice. The absence of recorded committee debate or amendments suggests little public opposition in the available record.
The main policy issue is whether physical therapists should be allowed to order diagnostic imaging directly and under what conditions. Any concern would likely center on patient safety, diagnostic accuracy, and maintaining appropriate referral and coordination with physicians, which the bill addresses by limiting the authority to qualified therapists and requiring prompt reporting to primary or specialty care providers. The near-unanimous votes suggest that any such concerns were minimal or resolved during drafting.