Direct access to physiotherapists: conditions and framework in 2026
Direct access to physiotherapists in 2026: open in coordinated practice, experimental in CPTS in 20 departments, 8 sessions without diagnosis, informing the doctor. The framework and the impact on written records.
Countries covered : France
Direct access changes the relationship between the patient and the physiotherapist: consulting without a prescription, under certain conditions. The framework remains precise and the practitioner's responsibility is reinforced.
This page reviews the conditions, limits, and impact on your written records, with a downloadable reference sheet.
The framework: general in coordinated practice, experimental in CPTS
Stemming from the RIST law (published on 20 May 2023), direct access to physiotherapists works at two levels. Since 22 August 2023, it has been open throughout France to physiotherapists working in a hospital or medico-social facility, a multi-professional health centre (maison or centre de santé), or a primary or specialist care team (ESP, ESS). For physiotherapists who are members of a CPTS (local health professional community), it remains experimental: 20 departments, until 31 December 2029 (decree of 27 June 2024).
If you practise within a CPTS, check with your regional health agency (ARS) or your CPTS that your department is one of the 20 in the trial.
Conditions and limits
What this changes for practice
Direct access empowers physiotherapists: it is up to them to identify what falls outside their scope of practice and refer to a doctor if necessary. This reinforces the importance of a solid physiotherapy diagnostic assessment (BDK) and rigorous traceability, especially since the BDK remains mandatory and audits are based on documentation.
Direct access reference sheet to download
Conditions, session limits, coordination with the doctor. Access the PDF by entering your email:
The impact on your written records
More autonomy means more written records to secure: BDK, session notes, and if necessary, a letter to the doctor for coordination. Start with a fixed template, standardise your phrasing, and dictate right after the session.
This is what Delta does: you capture your observations through live note-taking or post-session dictation, and the tool generates your structured assessments and notes according to your template, with longitudinal patient memory from one session to the next. HDS certified hosting, GDPR compliant.
Frequently asked questions
Can you consult a physio without a prescription in 2026?
Yes, without a prescription, if the physiotherapist works in a hospital, a health centre or a primary or specialist care team (throughout France since 22 August 2023), or in a CPTS in one of the 20 trial departments.
How many direct access sessions without a diagnosis?
Up to a maximum of 8 sessions per episode of care when there has been no prior medical diagnosis. Beyond that, the patient must be referred to a doctor.
Does direct access apply to all physiotherapists?
No. It covers physiotherapists in coordinated practice: hospitals, health centres and primary or specialist care teams throughout France, and CPTS in the 20 trial departments. A self-employed physiotherapist who belongs to none of these structures cannot see patients through direct access.
Is the BDK still mandatory?
Yes. The physiotherapy diagnostic assessment (BDK) remains mandatory; direct access even reinforces its importance.
Should the attending physician be informed?
Yes. The initial assessment and report are sent to the treating doctor and recorded in the shared medical record (DMP).
Further reading
- Physiotherapy diagnostic assessment (BDK): report template and structure
- Physiotherapy session notes: what to write down and template to download
- Home physiotherapy exercise programme: template and outline to download
- Delta, session notes and reports for physiotherapists
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