Direct access to physiotherapy in France 2026: who can practise, where and under what conditions
Since the Rist 2 Act, a patient can see a physiotherapist without a medical referral, but not everywhere, and not without rules. Eligible settings, the CPTS pilot running in 20 départements, the cap on sessions, reimbursement and obligations: the full picture for physiotherapists in 2026, with sources.
📝 In brief
- Direct access to physiotherapy, seeing a physiotherapist without a medical referral, comes from the Act of 19 May 2023 (known as Rist 2), but it does not apply everywhere, nor without conditions acces-direct.info.
- It is possible in health and social care institutions and in coordinated practice settings (MSP, health centres, ESP, ESS); a five-year pilot also opens it to physiotherapists belonging to a CPTS in 20 départements acces-direct.info.
- Without a prior medical diagnosis: 8 sessions maximum, then referral back to a doctor. Where a diagnosis has already been made (chronic condition, ALD long-term illness status): no cap on sessions acces-direct.info.
- The physiotherapist’s obligations: initial assessment + report sent to the patient’s GP and to the patient, and an entry in the DMP acces-direct.info. For invoicing, your own number goes in the « Prescriber » field ameli.fr.
📜 Sources used
- « Accès direct aux kinésithérapeutes: où en est-on? », acces-direct.info: website of the Accès direct collective, coordinated by the French national council of the physiotherapy professional body (CNOMK), 16 April 2026: acces-direct.info
- Circular CIR-13-2024 (invoicing for direct access), circulaires.ameli.fr: CIR-13-2024.pdf
- « Une étude démontre que l'accès direct à la kinésithérapie améliore les soins, tout en réduisant les dépenses publiques », acces-direct.info (CNOMK), 25 June 2026: acces-direct.info
Contents
🎯 Where does direct access come from? The Rist 2 Act
Direct access, the possibility for a patient to see a physiotherapist without a medical referral, comes from the Act of 19 May 2023 « improving access to care through trust in health professionals », known as the Rist 2 Act acces-direct.info. The aim: to simplify the care pathway at a time of doctor shortages, without removing the role of the GP, to whom the physiotherapist must refer the patient as soon as a diagnosis or a medical opinion becomes necessary acces-direct.info.
📍 Where is direct access possible?
It all depends on where the physiotherapist practises. Since 2023, direct access has been possible where the practitioner works in one of the following settings acces-direct.info :
- Public or private health institutions (hospitals, clinics…) and social care institutions (care homes…);
- Coordinated practice settings: multi-professional health centres (MSP), health centres (CDS), primary care teams (ESP) or specialist care teams (ESS).
A self-employed physiotherapist working « on their own », outside these settings and outside the CPTS pilot (below), therefore cannot offer direct access in 2026.
🧪 The CPTS pilot in 20 départements
A second scheme concerns physiotherapists who are members of a territorial professional health community (CPTS). Since the decree of 27 June 2024 and the order of 6 June 2025, a five-year pilot has allowed direct access in 20 départements acces-direct.info :
The 20 départements in the pilot: Aude, Côtes-d'Armor, Deux-Sèvres, Gers, Haute-Corse, Haut-Rhin, Isère, Loiret, Martinique, Mayotte, Meurthe-et-Moselle, Nord, Réunion, Rhône, Seine-Maritime, Tarn, Var, Vendée, Yonne and Yvelines acces-direct.info.
How do you take part? A physiotherapist whose place of practice is in one of these départements simply makes a declaration to the regional health agency (ARS); the list of authorised practitioners is published on each département’s ARS website. It is possible to join the pilot up to six months before it ends acces-direct.info.
🔢 How many sessions without a referral?
| Patient’s situation | Number of sessions in direct access |
|---|---|
| Medical diagnosis already made (chronic condition, long-term illness…) | No cap imposed: the physiotherapist decides how care is delivered acces-direct.info |
| Without a prior medical diagnosis | 8 sessions maximum; beyond that, the patient must be referred back to a doctor acces-direct.info |
💶 Reimbursement and the physiotherapist’s obligations
For the patient: under the agreement reached between the physiotherapy professional organisations and the Assurance Maladie, treatment delivered through direct access is reimbursed on the same terms as treatment delivered on referral acces-direct.info.
For the physiotherapist, direct access removes no responsibility whatsoever:
- Write an initial assessment as well as a report on the treatment given, sent to the patient’s GP and to the patient acces-direct.info ;
- Enter these documents in the patient’s shared medical record (DMP) of the patient acces-direct.info ;
- When invoicing, put your own number in the « Prescriber » field ameli.fr.
For the fee codes themselves, see our 2026 NGAP schedule.
📊 What the 2026 CNOMK study shows
In June 2026, a study by the physiotherapy professional body highlighted a large-scale failure to access physiotherapy care, because the current organisation remains too restrictive, and concluded that more direct access would improve patient care while reducing public spending acces-direct.info. Extending direct access, beyond the current settings and the CPTS pilot, is being pursued by the professional body as a major access-to-care issue; the framework may therefore change again.
❓ FAQ: Direct access to physiotherapy
Can you see a physiotherapist without a referral in 2026?
Yes, provided the physiotherapist works in a health or social care institution, in a coordinated practice setting (MSP, health centre, ESP, ESS), or takes part, through their CPTS, in the pilot currently running in 20 départements acces-direct.info.
How many physiotherapy sessions without a referral?
Without a prior medical diagnosis, 8 sessions maximum; beyond that, the physiotherapist must refer the patient back to a doctor. If a diagnosis has already been made (chronic condition, long-term illness), no cap is imposed acces-direct.info. On the Assurance Maladie side, the episode of care is capped at 8 sessions over a maximum of 3 months ameli.fr.
Are direct-access sessions reimbursed?
Yes: treatment delivered through direct access is reimbursed on the same terms as treatment delivered on referral, under the agreement between the professional organisations and the Assurance Maladie acces-direct.info.
How can a self-employed physiotherapist offer direct access?
Either by working in a coordinated practice setting (MSP, health centre, ESP, ESS), or, in the 20 départements taking part in the pilot, as a member of a CPTS, simply by declaring it to the ARS, which publishes the list of authorised practitioners acces-direct.info.
What are the physiotherapist’s obligations in direct access?
Write an initial assessment and a report on the treatment given, send them to the patient’s GP and to the patient, enter them in the DMP acces-direct.info, refer the patient to a doctor as soon as a medical opinion is needed, and put your own number in the « Prescriber » field when invoicing ameli.fr.
🎓 Direct access changes your practice: assessment, triage, referral
First contact without a medical diagnosis, a duty to assess and to refer on: direct access raises the demands on clinical reasoning. Our physiotherapy courses (on-site, virtual classroom and e-learning) are eligible for DPC and FIFPL funding: see our guides DPC 2026 and FIFPL 2026.
Information given for guidance only, always refer to the official text in force.
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