Can a PTA Do a Re-evaluation or Discharge? The Rules in Every State

No. In no state can a PTA re-evaluate a patient: 40 states and DC say so in their practice act or board rules, and the other 10 keep evaluation with the physical therapist. Discharge varies more. In 37 states the discharge decision, evaluation, plan or summary is the PT's, two states (Oklahoma and South Carolina) let a PTA write the discharge paperwork, and 12 jurisdictions don't mention discharge at all. What a PTA can do, in many states' own words, is gather the data, write the treatment notes, recommend discharge and sometimes make the last visit.

This article goes through every state for home health PTAs and the PTs who supervise them: the short answer, the rule it comes from with a link to the official text, and the exact words. I'm an occupational therapist, not a PT, so I've stuck to what the rules say. Medicare has its own rules on top, and they are in a separate section below.

This isn't legal advice. I checked every rule on November 9, 2026, on the state's own legislature, code or board site. Your board's current rule is the one that counts.

The Short Answer

• Re-evaluation: the PT's, everywhere. 40 states and DC name re-evaluation, reassessment or reexamination as the PT's job or as something a PTA may not do. The other 10 (Arkansas, Colorado, Connecticut, Illinois, Michigan, Minnesota, Montana, New Jersey, New York and Pennsylvania) keep evaluation with the PT without using the word. None lets a PTA do it.
• Many states also put the PT on a clock when a PTA treats, from every fourth visit in Arizona to every 60 days in Texas and in Oklahoma home health. Medicare home health adds its own 30-day reassessment.
• Discharge: the PT's in 37 states. The rules make the discharge decision, the discharge evaluation, the discharge plan or the discharge summary the PT's job. Delaware, Iowa, Oregon, Pennsylvania and Wyoming bar the PTA from the discharge itself.
• Two states let a PTA write the discharge paperwork. South Carolina's discharge note can be written by the PT or the PTA who gave the last treatment. Oklahoma's PT reviews a discharge summary the PTA prepares.
• 12 jurisdictions don't mention discharge in their PTA rules: DC, Arkansas, Florida, Illinois, Maine, Maryland, Michigan, Missouri, Montana, New Jersey, New York and Rhode Island. That isn't permission: all of them still treat evaluation as the PT's work.
• The last visit. Louisiana makes the PT treat the final session unless the patient is unavailable. Texas's board says a PTA may make the last visit. Iowa, Massachusetts, Nevada, New Jersey and Texas want the PT to see or reexamine the patient before a planned discharge.
• What a PTA may do is spelled out in many states: gather data for the PT's reassessment (Oregon, Wyoming, Kentucky, New Jersey), give the PT information for the discharge summary (Nebraska, Texas), recommend discharge (Oregon, Wyoming) and write the treatment notes.
• Medicare, separately: in home health only the therapist does the 30-day functional reassessment and the OASIS discharge assessment, and in Part B only the therapist writes the progress report.

Every State at a Glance

PT only means the act, the rules or the board say the task is the PT's or one a PTA may not do. Not named means the PTA limits never mention it, though the act or rules still treat evaluation as the PT's work. Each citation links to the official text I read.

The Rules That Matter Most in Home Health

Who makes the last visit

In home health the last visit is often a PTA visit, so this is where the rules bite.

• Louisiana puts the PT on the final visit. The supervising PT of record shall participate in the patient's care by "treating the patient for the final treatment session unless the patient is physically unavailable; and 4.writing the discharge summary." (La. Admin. Code tit. 46, pt. LIV, § 333(A) (opens in a new tab)) The same rule has the PT "treat and assess the patient for his final treatment session when feasible, as defined in §123, and write a discharge summary".
• Texas lets the PTA make it. The board's FAQ: "The 'last visit' is not addressed in the Board's rules. The rules do say that there must be a reevaluation prior to a planned discharge, which indicates that the PT must see the patient at some point prior to the last visit. The PTA may make the last visit and collect final data to report to the PT, but the decision to discharge, and the evaluative portion of the discharge summary, is the responsibility of the PT." (Texas Board of PT Examiners FAQ (opens in a new tab)) The rule it reads says PTA treatment "may not continue if the PT has not performed a reevaluation" every 60 days and "prior to any planned discharge" (22 TAC § 322.1(d) (opens in a new tab)).
• Ohio's board says the PT can do the discharge evaluation a little early. "Discharge planning and the completion of the discharge evaluation are the responsibility of the supervising physical therapist and may be performed and documented by the physical therapist in a reasonable timeframe prior to discharge. The physical therapist assistant may provide care per that discharge assessment and plan and may document objective information about that care, but the physical therapist must then complete the final discharge summary." (OTPTAT Board PT Section FAQ (opens in a new tab))
• Four more want the PT to see the patient before a planned discharge. Iowa: the PT shall "Directly participate in physical therapy services upon the physical therapist assistant's request for a reexamination, when a change in the plan of care is needed, prior to any planned discharge, and in response to a change in the patient's medical status" (481 IAC 801.4(3)(g) (opens in a new tab)). Massachusetts: the PT must "Perform reexaminations and document findings when a change in the Plan of Care is needed, prior to any planned discharge" (259 CMR 5.02(1)(c) (opens in a new tab)). Nevada: the supervising PT "Shall provide an evaluation before the patient is discharged, based upon the availability of the patient" (NAC 640.592(1)(e) (opens in a new tab)). New Jersey: under general supervision the PT makes an on-site visit "Prior to the planned completion of an episode of care" (N.J.A.C. 13:39A-7.2(c), 2019 adoption (opens in a new tab)).

Where a PTA can write the discharge paperwork

• Oklahoma. The PT of record shall "Establish the discharge plan and provide or review the documentation of the discharge summary prepared by the physical therapist assistant." The same rule sets the PT's re-examination for "every 60 days in home health settings with documented case consultation no less frequently than every 30 days." (Okla. Admin. Code 435:20-7-1(b) (opens in a new tab), the board's copy dated September 2023)
• South Carolina. The record includes "a discharge note which is a statement of the patient's status at the last treatment session as written, signed, and dated by the physical therapist or physical therapist assistant rendering service." The statute says nothing about who decides to discharge, and it still requires that "A patient must be reevaluated and the plan of care must be reapproved by a physical therapist licensed in this State every eighth treatment day or every sixty calendar days, whichever comes first." (S.C. Code §§ 40-45-280(C)(4), 40-45-300(B) (opens in a new tab))
• Virginia, by exception. The PT documents the patient's status at discharge, but "If a patient is discharged from a health care facility without the opportunity for the physical therapist to reevaluate the patient, the final note in the patient record may document patient status." (18VAC112-20-90(A) (opens in a new tab))
• North Dakota draws the line the other way. "Documentation other than the initial note and the discharge summary can be written by a physical therapist assistant." (N.D. Admin. Code 61.5-05-01-02(6) (opens in a new tab))

Where the state spells out what a PTA can contribute

• Oregon and Wyoming use almost the same words. Oregon: a PTA shall not "Perform the required reassessment provided in OAR 848-040-0155. However, a physical therapist assistant may participate with the physical therapist in gathering data to be included in the required reassessment of a patient for whom the assistant has been providing treatment." Nor "Independently make the decision to discharge a patient from therapy. However, a physical therapist assistant may make recommendations regarding discharge to the supervising physical therapist based on the assistant's treatment of the patient." (OAR 848-015-0030(1) (opens in a new tab)) Wyoming's version: a PTA may "participate with the physical therapist on gathering data to be included in the reassessment of a patient for whom the physical therapist assistant has been providing treatment" (Wyo. PT Board Rules ch. 7, § 5(c) (opens in a new tab)).
• Nebraska and Texas let the PTA feed the discharge summary. Nebraska: "The physical therapist assistant may participate in the discharge process for patient care by providing subjective and objective patient information to the supervising physical therapist." (172 NAC 137-008(F) (opens in a new tab)) Texas: "A PTA may participate in the discharge summary by providing subjective and objective patient information to the supervising physical therapist." (22 TAC § 322.1(e)(4) (opens in a new tab))
• Kentucky tells the PTA to stop. A PTA shall "Communicate with the physical therapist any change or lack of change that occurs in the patient's condition that may indicate the need for reassessment; and (8) Discontinue physical therapy services if reassessments are not done in compliance with Section 2(4) of this administrative regulation, and inform the supervising physical therapist." (201 KAR 22:053, § 3 (opens in a new tab)) Section 2(4) sets reassessment at "every thirty (30) days following the last evaluation or subsequent reassessment" for most patients.
• Georgia asks the PTA to flag it. "When the physical therapist assistant determines that the patient has received maximum benefits from physical therapy, he/she shall so inform the supervising physical therapist." (Ga. Comp. R. & Regs. 490-9-.03 (opens in a new tab)) Its PTA chapter also has a home health rule: the PT "in the home health setting responsible for the patient shall supervise the physical therapist assistant working with the patient and shall: (a) perform the initial patient evaluation to establish a physical therapy diagnosis, treatment goals, frequency, duration, and plan of care" (490-5-.01(4) (opens in a new tab)).
• Ohio's board on data: "It is the position of the Physical Therapy Section that physical therapist assistants may gather and summarize objective information; however, they may not interpret this data." And: "Relying solely on information gathered by the physical therapist assistant during treatment does not constitute a reassessment" (OTPTAT Board PT Section FAQ (opens in a new tab)).

The states that name both in one list

Some states put re-evaluation and discharge in the same sentence, which leaves nothing to interpret.

• Iowa, by statute: "The licensed physical therapist assistant shall not interpret referrals, perform initial evaluation or reevaluations, initiate physical therapy treatment programs, change specified treatment programs, or discharge a patient from physical therapy services." (Iowa Code § 148A.6(1) (opens in a new tab))
• Nebraska, by statute: "no physical therapist assistant shall perform the following: (a) Interpretation of physician referrals; (b) Development of a plan of care; (c) Initial evaluations or reevaluation of patients; (d) Readjustment of a plan of care without consultation with the supervising physical therapist; or (e) Discharge planning for patients." (Neb. Rev. Stat. § 38-2927(1) (opens in a new tab))
• California: "A physical therapist assistant shall not perform any evaluation of a patient or prepare a discharge summary." (Bus. & Prof. Code § 2630.3(d) (opens in a new tab)) Its rule adds that a PTA shall not "Write progress reports to another health care professional, as distinguished from daily chart notes" or "Be the sole physical therapy representative in any meeting with other health care professionals where the patient's plan of care is assessed or may be modified." (16 CCR § 1398.44(d) (opens in a new tab), in the board's Law Reference Guide)
• Mississippi and West Virginia share a list. West Virginia's, in force since April 7, 2026: "The physical therapist assistant may not perform the following physical therapy activities: 10.4.1. Interpretation of referrals; 10.4.2. Physical therapy initial evaluation and re-evaluation; 10.4.3. Identification, determination, or modification of plans of care (including goals and treatment programs); 10.4.4. Final discharge assessment/evaluation or establishment of the discharge plan" (W. Va. Code R. § 16-1-10.4 (opens in a new tab)).
• Delaware: "The Physical Therapist Assistant shall not perform interpretation of referrals, physical therapy evaluation and reevaluation, major modification of the treatment plan, final discharge of the patient, or therapeutic techniques beyond the skill and knowledge of the Physical Therapist Assistant without proper supervision." (24 Del. Admin. Code 2600-4.0 (opens in a new tab))
• Tennessee: "The discharge evaluation must be performed and the resulting discharge summary must be written by the licensed physical therapist." (Tenn. Comp. R. & Regs. 1150-01-.02(3)(b)4 (opens in a new tab))

The ten that don't use the word re-evaluation

These states keep evaluation with the PT in general terms. Arkansas's rule is the thinnest: the PT "must be readily available for consultation, evaluations, and establishment of each program" (17 CAR § 175-109 (opens in a new tab)). Michigan's rules only require that the PT "Examine and evaluate the patient or client before delegating acts, tasks, or functions performed by a physical therapist assistant" (R 338.7138(2)(b) (opens in a new tab)). New York and Pennsylvania use the same statutory phrase: PTA duties "shall not include evaluation, testing, interpretation, planning or modification of patient programs" (N.Y. Educ. Law § 6738 (opens in a new tab)). Pennsylvania adds a discharge line New York doesn't have: "A physical therapist assistant may not authorize the discharge of a patient from physical therapy services." (63 P.S. § 1309.1(h) (opens in a new tab))

What Medicare Adds (Separate From State Law)

Medicare's rules are payment and participation rules, not licensing rules. They apply on top of your state's, and when they differ the stricter one is the one you work to. If you want the supervision side (how often the PT has to come out when a PTA treats), our article on PTA supervision requirements by state covers it, and supervisory visit requirements in home health covers the Medicare visits.

Home health: the 30-day functional reassessment

The coverage rule for home health therapy: "At least every 30 calendar days a qualified therapist (instead of an assistant) must provide the needed therapy service and functionally reassess the patient in accordance with § 409.44(c)(2)(i)(A)." (42 CFR 409.44(c)(2)(i)(B) (opens in a new tab)) Miss it and visits "will not be covered" until the therapist has completed the reassessment. The same rule limits what a PTA's notes can say: "Clinical notes written by therapy assistants may supplement the clinical record" and "Assistants may not make clinical judgments about why progress was or was not made, but must report the progress or the effectiveness of the therapy (or lack thereof) objectively." (42 CFR 409.44(c)(2)(i)(E) (opens in a new tab)) And a maintenance program "must be established by a qualified therapist (and not an assistant)." (42 CFR 409.44(c)(2)(iii)(B)(2) (opens in a new tab))

How to count the 30 days, and what happens when the PT is late, is in our 30-day therapy reassessment guide. Which order a PTA's visits fall under is in which order an assistant works under.

Home health: the OASIS discharge assessment

The home health Conditions of Participation require the comprehensive assessment, with OASIS, to be updated "At discharge." (42 CFR 484.55(d)(3) (opens in a new tab)) For a therapy-only case, "a physical therapist, speech-language pathologist, or occupational therapist may complete the comprehensive assessment" (42 CFR 484.55(b)(3) (opens in a new tab)). The regulation doesn't name assistants. CMS's OASIS-E2 Guidance Manual, effective April 1, 2026, does:

A licensed practical nurse or licensed vocational nurse (LPN/LVN), physical therapist assistant (PTA), occupational therapy assistant (OTA), medical social worker (MSW), or home health aide may not be responsible for completing the comprehensive assessment and OASIS.

(OASIS-E2 Guidance Manual, ch. 1 (opens in a new tab))

The manual adds that "LPNs, PTAs, COTAs, MSWs, and home health aides are not disciplines authorized to complete the comprehensive assessment or collect OASIS data," and that when two qualified clinicians make discharge visits on the same day, "the last qualified clinician to see the patient is responsible for conducting the discharge comprehensive assessment." For an unplanned discharge, "the last qualified clinician who saw the patient may complete the discharge comprehensive assessment, including the OASIS, based on information from their last visit." A PTA is not a qualified clinician for this purpose. And "Multidisciplinary cases may have multiple points of discipline-specific discharge, though there is only one HHA discharge." (OASIS-E2 Guidance Manual (opens in a new tab))

So in a PT-only case, a planned agency discharge needs a PT visit for the OASIS, even in a state like Texas where a PTA may make the last treatment visit.

Part B outpatient: progress reports and the discharge note

For outpatient therapy, the Medicare Benefit Policy Manual says "information required in progress reports shall be written by a clinician that is, either the physician/NPP who provides or supervises the services, or by the therapist who provides the services and supervises an assistant." On assistants: "PTAs or OTAs may write elements of the progress report dated between clinician reports. Reports written by assistants are not complete progress reports. The clinician must write a progress report during each progress report period regardless of whether the assistant writes other reports." (Medicare Benefit Policy Manual, ch. 15, § 220.3(D) (opens in a new tab))

The discharge note "shall be a progress report written by a clinician," but the manual leaves the PTA one opening: "In the case of a discharge anticipated within 3 treatment days of the progress report, the clinician may provide objective goals which, when met, will authorize the assistant or qualified personnel to discharge the patient." The discharge note must then "indicate that the therapist reviewed the notes and agrees to the discharge." (Medicare Benefit Policy Manual, ch. 15, § 220.3(D) (opens in a new tab)) That Medicare opening doesn't override a state rule that keeps discharge with the PT. Section 230.1 sums up the assistant's role: "PTAs may not provide evaluative or assessment services, make clinical judgments or decisions; develop, manage, or furnish skilled maintenance program services; or take responsibility for the service." (Medicare Benefit Policy Manual, ch. 15, § 230.1 (opens in a new tab))

Planning a Discharge When a PTA Has the Case

None of this is legal advice. It is what the rules above have in common, put as steps for a home health team.

1. Put the PT's visits on the calendar first. The Medicare 30-day reassessment and any state clock (every sixth treatment day in Louisiana, every 30 days in many states) decide when the PT has to be in the home. The PTA's visits fit around them.
2. Schedule the discharge with the PT, not after it. In Iowa, Massachusetts, Nevada, New Jersey and Texas the PT sees the patient before a planned discharge. In Louisiana the PT makes the final visit. In Medicare home health a qualified clinician, never the PTA, does the discharge OASIS, whatever the state says.
3. Let the PTA do what the rules give them. Objective measures, the patient's own report, a recommendation that goals are met: Oregon, Wyoming, Nebraska and Texas say so in their rules, and most states let a PTA collect data.
4. Keep the judgment words in the PT's note. Whether progress was made, why, and whether to discharge are clinical judgments. Medicare says assistants report progress "objectively," and most states say the same in their own way.
5. Check the two outliers. In Oklahoma and South Carolina a PTA may write discharge paperwork, but the PT still sets the discharge plan or reapproves the plan of care.
6. Working in two states? If you treat in another state, in person, by telehealth or on a PT Compact privilege, that state's rule applies too.

Key Takeaways

• No state lets a PTA re-evaluate. 40 states and DC say so by name, and the other 10 keep evaluation with the PT.
• In 37 states the discharge decision, evaluation, plan or summary is the PT's. Oklahoma and South Carolina let a PTA write discharge paperwork. 12 jurisdictions don't mention discharge in their PTA rules.
• A PTA may make the last visit in some states (the Texas board says so) but not in Louisiana, and several states want the PT to see the patient before a planned discharge.
• Many states let a PTA gather data for the PT's reassessment and recommend discharge, and say so in their rules.
• Medicare home health needs a therapist for the 30-day reassessment and the OASIS discharge assessment. Part B needs a therapist for the progress report.
• This isn't legal advice. I checked these rules on November 9, 2026, and your board's current rule is the one that counts.

Frequently asked questions

Can a PTA do a re-evaluation?

No. None of the 50 states or DC lets a PTA re-evaluate a patient. In 40 states and DC, the practice act or the board's rules name re-evaluation, reassessment or reexamination as the physical therapist's job or as something a PTA may not do. The other 10 keep evaluation with the PT without naming re-evaluation. Several states let the PTA gather data for the PT's re-evaluation, and Medicare requires the therapist, not the assistant, to reassess home health patients at least every 30 days.

Can a PTA discharge a patient?

Not on their own. In 37 states the act, the rules or the board make the discharge decision, the discharge evaluation, the discharge plan or the discharge summary the physical therapist's job. Two states let a PTA write discharge paperwork: in South Carolina the discharge note can be written by the PT or PTA who gave the last treatment, and in Oklahoma the PT reviews a discharge summary the PTA prepares. The other 12 jurisdictions don't mention discharge in their PTA rules, but they still treat evaluation as the PT's work.

Can a PTA make the last visit before discharge?

In most states the rules don't say. The Texas board says a PTA may make the last visit and collect final data, but the decision to discharge and the evaluative part of the summary belong to the PT. Louisiana is the exception: the supervising PT must treat the patient for the final session unless the patient is physically unavailable. Iowa, Massachusetts, Nevada, New Jersey and Texas require the PT to see or reexamine the patient before a planned discharge. In Medicare home health, a PTA can't do the OASIS discharge assessment.

Can a PTA do the 30-day reassessment in home health?

No. Medicare's home health rule, 42 CFR 409.44(c)(2)(i)(B), says a qualified therapist, instead of an assistant, must provide the needed therapy service and functionally reassess the patient at least every 30 calendar days. The PTA can keep treating between those visits. Some states add a shorter clock of their own on top, such as every sixth treatment day in Louisiana and every seventh visit in DC.

Can a PTA write progress notes?

Yes, in the states that address it. Louisiana says a progress note is created and signed only by the supervising PT or the PTA, and North Dakota lets a PTA write everything except the initial note and the discharge summary. For Medicare Part B, a PTA may write elements of the progress report between the therapist's reports, but those are not complete progress reports, and the therapist must write one every reporting period. DC, New Hampshire, New Jersey and South Carolina require the PT to co-sign PTA notes in some form.

Sources

Every state's rule is linked in the table, to the state's legislature, its official administrative code publisher or its PT board. Board FAQs and statements are labeled as such. All were read on November 9, 2026.

• 42 CFR 409.44 (opens in a new tab) (eCFR): (c)(2)(i)(B) the 30-day reassessment, (c)(2)(i)(E) assistants' notes, (c)(2)(iii)(B)(2) maintenance programs.
• 42 CFR 484.55 (opens in a new tab) (eCFR): (b) who completes the comprehensive assessment, (d)(3) the discharge update.
• CMS, OASIS-E2 Guidance Manual (opens in a new tab), effective April 1, 2026: chapter 1 and the M0080 item guidance.
• CMS, Medicare Benefit Policy Manual, chapter 15 (opens in a new tab): § 220.3(D) progress reports and the discharge note, § 230.1 physical therapist assistants.
• Board guidance quoted above: Texas Board of PT Examiners FAQ (opens in a new tab), Ohio OTPTAT Board PT Section FAQ (opens in a new tab), South Dakota Board of PT guidance (opens in a new tab) and the New York PTA practice FAQ (opens in a new tab).
• Related on this site: the PT and PTA student supervision rules and holding both a COTA and a PTA license.