Forty-four states have some form of direct access. Some state physical therapy practice acts require a diagnosis before a patient can see a therapist (this is the case in California, Michigan, and Colorado to name a few). Other states allow patients to go directly to physical therapists. In most cases, if you are not making significant improvement within 30 days, the therapist will refer you to/back to your physician. Seeing a physical therapist first is safe and could save you hundreds of dollars.