Illinois Updates Telehealth Rules for Physical Therapists

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Guidelines in Illinois aim to balance virtual and in-person care. Learn how the changes are shaping telehealth services for physical therapists.

(Updated October 14, 2025)

In 2024, Illinois Governor JB Pritzker signed House Bill 5087, which placed guardrails around the practice of physical therapy through telehealth. These guardrails, which took effect January 1, 2025, affected the many therapists who incorporated telehealth care into their routine practice because of the COVID-19 pandemic and the ongoing pressure to expand access to care.

On August 15, 2025, Governor Pritzker signed Senate Bill 2153, which further amended the Illinois Physical Therapy Practice Act to clarify the earlier changes made by HB 5087. Learn what the updated Act requires for PTs who have embraced telehealth as a mode of care.

Telehealth Provisions and Requirements

Together, bills updated the Illinois Physical Therapy Practice Act to include provisions for telehealth. Under these changes, physical therapists licensed in Illinois are expressly authorized to provide physical therapy services via telehealth, as long as at least one of the following criteria applies:

1. The patient has a referral or diagnosis from a health care professional.
2. The patient has an established relationship with the physical therapist. 
3. The physical therapist has the capacity to perform or facilitate a referral for an in-person, hands-on examination or re-examination by a physical therapist at any time during the patient’s care.

Effects on Physical Therapists and Patient Care

The Illinois Physical Therapy Association helped draft and pass HB 5087, touting enhanced protections for access to care. They emphasized that it ensures telehealth remains available without replacing in-person care as the primary method for delivering physical therapy services. 

However, HB 5087 would likely have impeded some providers’ ability to expand their patient network because it required physical therapists who provide telehealth services to maintain the capacity to provide in-person care within Illinois. Critics of HB 5087 warned that the capacity requirement could have far-reaching effects, such as requiring out-of-state licensees to maintain physical office space in Illinois or forcing providers to offer mobile in-home services to patients who request in-person care. 

SB 2153 removed HB 5087’s language stating that the use of telehealth as a primary means of delivering physical therapy must be an exception and that clinicians must document the clinical justification for telehealth. The updates introduced in SB 2153 will likely remove barriers for both telehealth physical therapists and patients seeking telehealth-based physical therapy services.

Considering the Physical Therapy Licensure Compact

Now that SB 2153 has been signed, it further amends the Physical Therapy Practice Act and clarifies HB 5087’s provisions, reducing the likelihood that the Act will impede the pending Physical Therapy Licensure Compact, which the Senate approved last year and the House is now considering. If enacted, the interstate licensure compact aims to make it easier for providers licensed in other participating states to obtain an Illinois license and provide physical therapy services to patients in Illinois.

Steps for Telehealth Providers

Physical therapists who routinely provide physical therapy via telehealth should consider several factors when contemplating how their practice could change.

First, review your new patient intake policies and procedures. What do they tell new patients about your scope of practice for telehealth? Do you need to adjust them to include an option to request in-person care during the course of their treatment? Do they explain that you may require in-person visits to ensure the same standard of care as other patients you treat, whether in person or virtually? If you do not have the capacity to perform in-person evaluations or re-evaluations, do you have a colleague to whom you can provide a referral for an in-person evaluation?

Second, are you an out-of-state licensee or an in-state licensee with a fully virtual practice? If so, how will you ensure that patients receive the same standard of care virtually and in person? This could mean obtaining office space in Illinois to offer in-person treatment when necessary. Or it could mean providing mobile, in-person services to satisfy any need for in-person care. If you provide physical therapy through an employer, ask whether the organization has updated policies or procedures to support continued telehealth care.

Get Legal Support

Whether you’re currently licensed in Illinois or planning to get licensed soon, evaluating your patient care priorities and updating your practice’s policies and procedures is essential for staying compliant. Consulting with an experienced healthcare attorney can help ensure your policies are not only compliant with current laws but also adaptable to possible future changes in the law. If you operate in one of the states where we have licensed attorneys, schedule an initial complimentary consultation to learn more.

This blog is made for educational purposes and is not intended to be specific legal advice to any particular person. It does not create an attorney-client relationship between our firm and the reader. It should not be used as a substitute for competent legal advice from a licensed attorney in your jurisdiction.