Orthotists and Prosthetists

The Orthotists and Prosthetists program regulates orthotists and prosthetists, orthotic and prosthetic assistants, students, and technicians, and orthotic and prosthetic facilities. A license is required to provide orthotic and prosthetic services in Texas, unless an individual or facility is exempted by law.

Orthotic and Prosthetic services comprise the science and practice of measuring, designing, fabricating, assembling, fitting, adjusting, or servicing an orthosis or prosthesis for the correction or alleviation of a neuromuscular or musculoskeletal dysfunction, disease, injury, or deformity.

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News and Updates

Proposed Rule Changes

The Texas Department of Licensing and Regulation proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 114, §§114.20-114.22, 114.27, 114.29, 114.40, 114.50, 114.75, and 114.80, regarding the Orthotists and Prosthetists Program.  The proposed rules implement changes identified by the Department as a result of the four-year rule review process conducted under Texas Government Code §2001.39. The proposed rules update rule provisions to reflect current Department procedures, amend outdated rule language, and eliminate unnecessary fees.

The proposed rules were published in the November 5, 2021, issue of the Texas Register (46 TexReg 7485).  The Department will accept comments on the proposal until December 6, 2021.

The Department encourages anyone interested in the Orthotists and Prosthetists Program to review the rule proposal online at www.sos.texas.gov.  Comments may be submitted electronically on the Department’s website at https://ga.tdlr.texas.gov:1443/form/gcerules.

Continuing Education Requirements

HB 1560, the Sunset legislation for the Texas Department of Licensing and Regulation, repealed Occupations Code §605.261 from the Orthotists and Prosthetists statute, and transferred authority regarding the continuing education requirements to TDLR’s enabling statute, Chapter 51 of the Texas Occupations Code.

Please note that no changes were made, and Orthotists and Prosthetists program licensees are still required to obtain continuing education (CE) credits as specified in the program rules.

Call for Subject Matter Experts

TDLR is seeking subject matter experts (SMEs) to assist our Enforcement Division with complaint case reviews. SMEs review complaint cases, generally involving standard of care issues, during the investigation stage of the enforcement process.

If you are interested in becoming a SME, please complete the Expert Witness Application. Once the application is submitted, you will receive a questionnaire to complete and return. Documents are screened and contracts are issued to approved SMEs.

All SMEs receive training on their role in reviewing complaint cases. Tasks may include the following:

  • Reviewing documents and statements collected by investigators.
  • Writing a report stating an opinion as to whether the respondent violated a rule or law in the provision of care to a client.
  • Answering specific questions from the prosecutor about the case.
  • Testifying as a witness for TDLR at hearings.

Our mission is to protect the citizens of Texas and the hard-working members of your profession. We cannot do that without your specialized knowledge of the complexities of your profession. Please consider becoming a SME today.

TDLR Health Monitor – August 2021 Edition

Articles in this August 2021 edition of The Health Monitor includes updates on:

  • 2021 Legislative Session
  • Commissioner Spotlight
  • Athletic Trainers Mark 50 Years
  • Revised Massage Therapy Sample Consultation Document Available
  • How to File a Complaint

Rule Review Adoption Justification

At their meeting held March 3, 2021, the Texas Commission of Licensing and Regulation adopted the rule review of 16 Texas Administrative Code (TAC) Chapter 114, Orthotists and Prosthetists, effective March 15, 2021.

The rule review adoption was published in the March 26, 2021 issue of the Texas Register (46 TexReg 2050).

TDLR encourages all persons interested in the Orthotists and Prosthetists program to review the rule review adoption. The adoption justification is available online.

Notice to prospective licensees, current licensees renewing their licenses, and stakeholders

Applicants can apply for new licenses and renew licenses online. TDLR strongly encourages you to take advantage of the opportunity to apply or renew online. The process is secure and easy to use – and faster than submitting paper-based applications and supporting documents, especially as TDLR deals with significant staffing issues related to COVID-19.

  • Applications submitted online can take 30 days to process once TDLR receives all required documents.
  • Applications submitted by mail may face significant delays, which may take up to 90 days once TDLR receives all required documents.

Access the online licensing system here. If you need to submit a document outside of the online application, please scan the document and send it to TDLR using our online customer service form.

If you need to submit a transcript, please ask your university to send electronic transcripts to TDLR at cs.transcript@tdlr.texas.gov instead of mailing in an original or certified copy of an original transcript. If your need to submit other documents, such as receipt of fingerprint submission, please scan the document and send it electronically to TDLR using our Customer Service form.

Thank you for helping us process your application or renewal more quickly.

86th Legislative Session Update

Notice to Health Care Practitioners of New Training Requirement

House Bill 2059 requires certain health care practitioners to complete a Health and Human Services Commission (HHSC) approved human trafficking prevention training course to renew their license. The bill also requires HHSC to post a list of approved courses on their website. Licensees are required to comply with the training requirements beginning September 1, 2020. For more information, visit our Human Trafficking Prevention Training for Health Care Practitioners webpage.

Updates to Orthotists and Prosthetists law(s)

House Bill 2847 passed by the 86th Texas Legislature, amended Occupations Code, Chapter 605, relating to the licensing and regulation of certain occupations, activities, and agreements; providing a civil penalty; authorizing fees; requiring an occupational registration and an occupational license. House Bill 2847 and the changes to Chapter 605 became effective September 1, 2019. TDLR encourages all persons interested in the Orthotists and Prosthetists program to review the updated Occupations Code, Chapter 605.

Governor Approves Regulatory Suspensions to Facilitate Services to Orthotist and Prosthetist Clients During the COVID-19 Pandemic

To help combat the spread of Coronavirus, TDLR requested and received authority from Governor Greg Abbott to suspend certain regulatory requirements to provide Orthotists and Prosthetists with more flexibility regarding oversight of facility operations.

This suspension is in effect until terminated by the Office of the Governor or until the March 13, 2020 disaster declaration is lifted or expires.

In accordance with Section 418.016 of the Texas Government Code, the Office of the Governor has granted TDLR’s request to suspend Texas Occupations Code §605.260(c), suspending the requirement that a licensed orthotist and/or prosthetist provide on-site direction at an accredited facility.

COVID-19: Continuing Education Waived

TDLR continuing education requirements are waived for all individual licenses expiring in March, April, and May 2020. Licensees still need to submit their renewal applications, pay the required fees, and TDLR will check their criminal histories, but they will not need to complete any TDLR-required continuing education this licensing cycle. (§51.405, Occupations Code)

Note: TDLR is not authorized to waive continuing education requirements imposed by a certifying or credentialing entity other than TDLR. If a certifying entity requires continuing education to maintain certification, and certification is required for Texas licensure, then that continuing education must be completed. If the certifying entity waives continuing education or allows it to be completed on a delayed basis due to COVID-19, then you may follow the certifying entity’s policy.

Please check the TDLR COVID-19 webpage for the most up-to-date information.

Guidance Statement on TDI Rules Related to Senate Bill 1264

The Texas Department of Insurance (TDI) has adopted emergency rules interpreting Senate Bill (SB) 1264’s prohibitions related to “surprise billing” (or “balance billing”). This Guidance Statement is intended to provide clear information concerning SB 1264 to Texas patients, clients, and health care providers under the regulatory authority of the Texas Department of Licensing and Regulation (TDLR).

SB 1264 prohibits surprise billing, with certain exceptions. Health care providers under TDLR’s regulatory authority who seek to exercise the exceptions to SB 1264’s prohibitions against balance billing must comply with all provisions of SB 1264, including as interpreted by TDI rules. See the TDI SB 1264 webpage for additional information. SB 1264 applies to a health care or medical service or supply provided on or after January 1, 2020.

TDLR will be responsible for investigating complaints and taking disciplinary action against TDLR licensees for violations of SB 1264, including as interpreted by TDI rules. Any person who believes that a TDLR-licensed health care provider has committed a balance billing-related violation may file a complaint online with TDLR. Additionally, TDLR and TDI will work together to ensure that any complaints filed with TDI regarding TDLR licensees will be referred to TDLR and investigated.

TDLR will be working on the development of enforcement rules consistent with SB 1264 and TDI’s rules interpreting the statute. As rulemaking moves ahead, we look forward to a transparent process and engaging the public and stakeholders on this important issue.

Orthotists and Prosthetists: One Year Update

In 2015, the Texas Legislature passed Senate Bill 202, transferring the Orthotists & Prosthetists program from the Department of State Health Services (DSHS) to the Texas Department of Licensing & Regulation (TDLR).

The program transfer took place in October 2016. As part of our mission to deliver improved services at a lower cost to Texans, TDLR reduced the following fees for the Orthotists & Prosthetists program:

Orthotists & Prosthetists DSHS Fee TDLR Fee $ Reduced % Reduced
Jurisprudence Exam $35 $34 $1 3%
Written License / Certification Verification Fee $25 $0 $25 100%
Changing the name of an accredited orthotics or prosthetics facility $400 $50 $350 88%
Changing the name of an accredited orthotics and prosthetics facility $500 $50 $450 90%
Changing the name of the on-site practitioner in charge of an accredited facility $100 $50 $50 50%
Changing the name of the safety manager of an accredited facility $100 $50 $50 50%
Criminal History Evaluation Letter $50 $25 $25 50%
Reinstatement Fee $100 $0 $100 100%

We’ve also reduced processing and administrative fees for each online transaction. Thanks to these reductions, Texas Orthotists & Prosthetists kept $3,857.00 in their pockets in their first year at TDLR. (October 2016 – September 2017)

In addition, TDLR reduced the word count in the Orthotists & Prosthetists program administrative rules to make them clear, concise, and easier to read--without impacting their effectiveness:

Orthotists & Prosthetists DSHS Rules TDLR Rules Word Difference % Reduced
Administrative Rules Word Count 24,948 12,611 12,337 49%

At TDLR, one of our core values is open and free communication. During this first year, the 3,913 Orthotists & Prosthetists program email subscribers were contacted 15 times (58,695 emails delivered) so that we could share information about meetings, rule changes, licensing, and more. And beginning in November 2015, all interested parties have been invited to six public meetings of the Orthotists & Prosthetists Advisory Board

TDLR is delivering on our promise to promote transparency and accountability, protect the health and safety of all Texans, and eliminate unnecessary barriers to doing business. We look forward to serving you for many years to come, and always appreciate any feedback.

Inspection Information for Owners and Practitioners-in-Charge of Orthotic and Prosthetic Facilities

Rules reviewed by the Orthotists and Prosthetists Advisory Board and approved by the Texas Commission of Licensing and Regulation require that Orthotic and Prosthetic facilities be inspected once every two years. Inspectors from TDLR’s Field Operations Division will perform unscheduled inspections during your regular business hours beginning in March 2017.

Inspectors will check that your accredited facility is complying with the sanitation, safety, record-keeping and licensing requirements of the law and rules. Inspectors will explain in detail any violations that are noted, what corrective actions to take, and give you a chance to ask questions.

Inspection results fall into one of the following three categories:

  • No Corrections Needed – No action required. Your facility is in compliance.
  • Corrections Needed – Make corrections within 10 days of the inspection date.
  • Violations Sent to Enforcement – Make corrections within 10 days of the inspection date. In addition, a representative of the Enforcement Division may contact you regarding the violations.

During this first round of inspections, only very serious violations, such as unlicensed activity, will be referred to the Enforcement Division. Inspectors will use an Orthotic and Prosthetic Facilities Reference Guide to help them perform inspections. The Orthotic and Prosthetic Facilities Reference Guide (393kb PDF) is available online.

Advisory Board Meetings

October 21, 2021

The Orthotists and Prosthetists Advisory Board met October 21, 2021 via videoconference. The meeting was archived and is available on TDLR’s YouTube channel. The agenda and staff reports are available online.