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Coursework Tools for Foreign Educated PTs and PTAs

Helping members evaluate foreign-educated candidates


Agencies licensed to use the coursework tools

  • Foreign Credentialing Commission on Physical Therapy
  • CGFNS for use by ICD (International Consultants of Delaware)
  • International Education Research Foundation

Credential Review Agency Standards

Although the licensing of physical therapists (and physical therapist assistants) in the US is a right and responsibility of each jurisdiction, foreign educated individuals must undergo an educational credentials assessment for substantial equivalency to the first professional degree in the US. The Federation of State Boards of Physical Therapy (FSBPT) is committed to protect the public and to provide leadership within the field and practice of physical therapy.

FSBPT’s Foreign Educated Standards Committee (retired in 2018) developed standards that represent “best practices” in evaluation services. The Credentials Evaluation Standards were developed with input from the physical therapy credentialing agencies that are licensed to use FSBPT’s Coursework Tool (CWT).

A questionnaire has been developed based on this document and each credentialing agency has been offered the chance to provide answers and documentation to the Federation based on the questionnaire. It is intended that this document and the questionnaire be used by the jurisdictions as a tool to help verify the quality of credential evaluation services.

The questionnaire responses are maintained by the Federation and are available to FSBPT member jurisdictions by requesting (in writing or via email) copies of agency responses to


View the coursework tools:

PT tools:

PTA Tool:


Development of the Coursework Tools

Coursework tools (CWT) for foreign educated physical therapists (CWT 1-6)

Prior to 1955 the oversight of physical therapist education came under the auspices of the American Medical Association (AMA). These standards were established by the AMA’s Council on Medical Education and Hospitals. When APTA took on this oversight function, they adopted AMA’s educational criteria. These criteria and expectations were for physical therapists, physical therapist clinics and physical therapy programs to be under the direction and prescription of the physician. CWT 1 reflects the educational program required of a physical therapist who graduated prior to 1978.

In 1978, the APTA House of Delegates adopted and implemented the first changes in the evaluative criteria since 1955. CWT 2 reflects those changes in philosophy and criteria for PT education.

By 1990, the Commission on Accreditation in Physical Therapy Education (CAPTE) had been created for the purposes of accrediting physical therapy programs within the standards set by the U.S. Department of Education. CAPTE established new guidelines and Evaluative Criteria for the PT educational programs, which were adopted by the APTA House of Delegates. Implementation occurred in 1992. CWT 3 was developed from these standards.

In 1998, the CAPTE Evaluative Criteria were revised. CWT 4 is based upon the 1998 criteria. In addition, FSBPT used information compiled by the FSBPT Foreign Educated Physical Therapist Committee from 1998-1999, A Normative Model of Physical Therapist Professional Education: Version 97, APTA, 1997 and reviewed catalogs of institutions offering physical therapist educational programs and guidelines from 49 jurisdictions for licensing foreign educated physical therapists. Research done by the New Jersey State Board of Physical Therapy Education Committee and an analysis of requirements of 53 licensing jurisdictions completed by International Credentialing Associates were also considered in the establishment of CWT 4.

CWT 4 was validated against the 1988 Evaluative Criteria for Accreditation of Educational Programs for the Preparation of Physical Therapists, and modified in 2002 to include terminology and concepts published in professional reference documents that describe contemporary education and practice in the U.S. such as the Guide to Physical Therapist Practice Second Edition, APTA, January 2001.

During this timeframe, INS (now USCIS) published rules requiring agencies that provided visa screening for healthcare workers to conduct ongoing validation studies of the tools used to assess candidates for certification. This requirement applied to the Coursework Tool because FCCPT, an agency recognized by USCIS to provide visa screenings, used (and uses) the FSBPT Coursework Tool. A validation study conducted at Northwestern University was completed in 2003. Modifications in terminology to CWT 4 were made from recommendations from the Validation Study to bring it into compliance with the then-current CAPTE evaluative criteria.

CWT 5 was prepared and validated by FSBPT upon the publication of the Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapists effective January 1, 2006. It was adopted by the FSBPT board of directors to be used beginning July 1, 2009. This date reflects graduation of students taught under the 2006 criteria.

CWT 6 was prepared and validated by FSBPT based upon the August 2014 publication of CAPTE’s Evaluative Criteria for PT Programs. It was adopted by the FSBPT board of directors to be used beginning January 1, 2017. This date reflects graduation of students taught under the 2014 criteria.

Chronologically, the first coursework tool actually developed was CWT 4, which encompassed the accreditation standards in place at the time of its development around 1999-2000. In 2004, the Federation’s delegate assembly charged the board of directors to develop and validate different forms of the CWT, based upon earlier versions of the CAPTE evaluative criteria to be used for endorsement candidates. Endorsement candidates are defined as individuals already licensed to practice in a US jurisdiction who are requesting licensure in another US jurisdiction.

Use of the CWT

The CWT that reflects current standards may be used to determine qualifications for an applicant to sit for the NPTE, for first-time licensure in US jurisdictions and prescreening certification for the United States Citizenship and Immigration Services (USCIS).

Per the following motion passed by the 2014 Delegate Assembly, CWTs that reflect previous standards may be used to determine qualifications for licensure through endorsement of a foreign educated PT or PTA who is already licensed, certified or registered in another US jurisdiction.


The credentials of a foreign educated physical therapist (FEPT) who is currently licensed in a jurisdiction, and is seeking licensure through endorsement in another jurisdiction should be evaluated using the version of the FSBPT Coursework Tool retro tool that covers the date the applicant graduated from their respective physical therapy education program.

This process should be used for those seeking licensure through endorsement only. First-time licensure candidates should be evaluated using the current Coursework Tool. In addition, rescind Delegate Assembly motion DEL-05-10.

CWTs are also designed to be used by credentialing organizations and education programs. In addition, the CWTs may be used as a self-evaluation method to guide foreign educated physical therapists in comparing their education to US standards.

Coursework tool for foreign educated physical therapist assistants (PTA-Tool 1-2)

PTA-Tool 1 was developed by the Federation in response to the 2008 published regulation number CMS-1385 by the Centers for Medicare and Medicaid Services (CMS) for Medicare reimbursement. This CMS regulation requires a foreign educated physical therapist assistant to show certification of education which is substantially equivalent to an entry-level physical therapist assistant’s education in the United States.

PTA-Tool 2 was developed by the Federation in 2017 to address the changes in the Commission on Accreditation of Physical Therapy updates to the Evaluative Criteria for accredited PTA programs. The PTA-Tool 2 was approved and adopted by the Board of Directors in February of 2017 with recommended implementation February 2017.

PTA-Tool 1 reflects the minimum foundational studies and applied science and technical education for substantial equivalence with respect to a U.S. first degree for a physical therapist assistant.

PTA-Tool 1 is validated against the CAPTE Evaluative Criteria for Accreditation of Education Programs for the Preparation of Physical Therapist Assistants adopted April 2006 and effective July 1, 2007.

More tools

Below are more tools that FSBPT has developed for state licensing authorities in the regulation of physical therapy.

  • Legislative tracking tool

    Track legislative issues important to your state.

  • Licensure reference guide

    Compare the requirements of various jurisdictions.

  • Minimum Data Set

    The MDS will allow physical therapy to answer questions that will determine, among others, the number of providers; the race and sex of these individuals; and the facilities and geographic location in which services are provided.

  • Model practice act

    Read about the most effective tool for modernizing physical therapy practice acts.

  • NPDB basis for action

    Learn about this alert mechanism for sanctioned individuals.

  • Remediation resources

    Read detail information about ethics remediation courses.

  • Scope of practice

    Use this tool to help you make decisions about the physical therapy scope of practice in your state.

  • Telehealth in Physical Therapy

    The purpose of this document is to provide information and general guidance to physical therapy jurisdictional authorities for regulating the use of telehealth technologies in the practice of physical therapy.