Orthotists and Prosthetists Frequently Asked Questions

Telehealth Practice

1. What is Telehealth?

Telehealth is a health service delivered by a health professional acting within the scope of the health professional's license to a client at a different physical location than the health professional using telecommunications or information technology. 

2. Can Orthotists and Prosthetists Practice telehealth?

As health professionals, Orthotists and Prosthetists can practice telehealth.  This option for care can be used if it is appropriate for the type of treatment being provided. The applicable standard of care for telehealth treatment is equal to an in-person appointment.  The use of telehealth must be for a service within the existing scope of practice for Orthotists and Prosthetists and their Assistants. This is further described in  Texas Occupations Code § 51.501, the law governing telehealth for TDLR’s health professional licensees.

Orthotic and/or Prosthetic Assistants may not be remotely supervised by a LPO, LO or LP using telecommunications or information technology in the performance of a critical care event.

3. What about Orthotic or Prosthetic Assistants?

It is outside the scope of practice of an assistant to perform a critical care event without the supervising orthotist or prosthetist physically in the room, meaning these services cannot be provided by an assistant via telehealth.

Critical care events are defined in the Orthotics and Prosthetics Rules as initial patient assessment, prescription development and recommendation, appropriate patient education and training and final evaluation and assessment of fit and function of the custom-fabricated prosthesis or orthosis.

4. Is there a different standard of care for Telehealth?

No. 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.  If that service can be done to the same standard of care using telehealth as an in person visit while complying with the profession's laws and rules, then telehealth is an option for that service. Orthotists and Prosthetists providing telehealth services should be prepared to meet all applicable requirements, including documentation and recordkeeping, for an in-person service of the same type.

Jurisprudence Examination

1. I took the jurisprudence exam for my DSHS license. Do I have to retake the jurisprudence exam?
No, if you took the DSHS jurisprudence exam to receive your initial license, you will not need to retake it. However, if your profession requires you to retake the jurisprudence exam for license renewal, you will take the new TDLR version of the jurisprudence exam, which is based on the law and the TDLR rules for your profession. Orthotists/Prosthetists licensees must successfully complete the jurisprudence exam every other renewal.

2. How often do I have to take the Jurisprudence exam?

All licensees and registrants (except Students, Temporaries and Facilities) must complete the JP Exam every other renewal. You will need the date your license was initially issued; this date can be found using TDLR's Online Licensing Services.

  • If you were first licensed in 1999, 2003, 2007 or 2011, you must complete the JP Exam in 2015/2016, 2019/2020, 2023/2024, etc.
  • If you were first licensed in 2000, 2004 or 2008, you must complete the JP Exam in 2018/2019, 2022/2023, 2026/2027, etc.
  • If you were first licensed in 2001, 2005 or 2009, you must complete the JP Exam in 2017/2018, 2021/2022, 2025/2026, etc.
  • If you were first licensed in 2002, 2006 or 2010, you must complete the JP Exam in 2016/2017, 2020/2021, 2024/2025, etc.
  • If you were first licensed in 2012, you must complete the JP Exam in 2016/2017, 2020/2021, 2024/2025, etc.
  • If you were first licensed in 2013, you must complete the JP Exam in 2017/2018, 2021/2022, 2025/2026, etc.
  • If you were first licensed in 2014, you must complete the JP Exam in 2018/2019, 2022/2023, 2026/2027, etc.
  • If you were first licensed in 2015, you must complete the JP Exam in 2019/2020, 2023/2024, 2027/2028, etc.
  • If you were first licensed in 2016, you must complete the JP Exam in 2020/2021, 2024/2025, 2028/2029, etc.
  • If you were first licensed in 2017, you must complete the JP Exam in 2021/2022, 2025/2026, 2029/2030, etc.
  • For all new licenses issued by TDLR, you will take the JP Exam at your second renewal (no continuing education or JP Exam required at the first renewal) and every other renewal after that.

Take the JP Exam no more than six months before you renew.

See the TDLR rule concerning the JP Exam at 16 Texas Administrative Code, §114.21(b).


License Required

1. Does the delegated authority of a physician, as outlined by the Texas Medical Practice Act, allow unlicensed individuals to practice orthotics or prosthetics in Texas?

The delegated authority of a licensed physician does not allow unlicensed individuals to practice orthotics or prosthetics in the State of Texas.

The Texas Orthotics and Prosthetics Act (Texas Occupations Code, Chapter 605) requires licensure for individuals practicing orthotics and prosthetics within the state. The Act does provide exemptions to several licensed and certified professionals as outlined in Subchapter G, these include physical therapists, occupational therapists, chiropractors, podiatrists, pharmacists, and certified pedorthists.

In comparison, the Texas Medical Practice Act (Texas Occupations Code, Chapter 151) authorizes licensed physicians to diagnosis, treat, or offer to treat a mental or physical disease or disorder or a physical deformity or injury by any system or method. These provisions include the practice of orthotics and prosthetics in the performance of a physician's duties. In addition, a physician may delegate authority to individuals; however, there are specific guidelines that govern delegated authority. Texas Occupations Code, Chapter 157, §157.001(a)(1)(C) states that a physician may delegate authority if the delegation, "is not in violation of any other statute."

Because the practice of orthotics and prosthetics is protected by statute, the Texas Medical Practice Act prohibits a physician from delegating authority to an unlicensed individual to perform any act within the scope of practice defined by the Texas Orthotics and Prosthetics Act.

2. Who can fit and sell diabetic shoes in Texas?

The Texas Orthotics and Prosthetics Act (Texas Occupations Code, Chapter 605) includes in its definition of the practice of orthotics, the fitting of a custom-fitted or custom-fabricated device.

These definitions are outlined in Sections 605.002 (3), (4), (12), and (14).

Any individual who custom fits a diabetic or other shoe through means of moldable inserts or other methods, regardless of where the final shoe is manufactured, is practicing orthotics and must be licensed under the Texas Orthotics and Prosthetics Act, unless exempt (see below).

Professional certifications from private educational companies do not constitute Texas licensure. Any unlicensed individual who is discovered to be practicing orthotics in this manner will be subject to enforcement action which may include administrative, civil, and criminal penalties.

The Act does recognize several professions that are exempt from these provisions. Exempt professions are limited to licensed podiatrists, chiropractors, occupational therapists, physical therapists, and pharmacists. Certified pedorthists are also exempt from licensure under the Texas Orthotics and Prosthetics Act.

Furthermore, the sale of retail shoes, over-the-counter or out of the box, is not subject to the Texas Orthotics and Prosthetics Act.

3. Is a certified orthotic fitter authorized to practice in Texas?

No. Any person practicing orthotics in Texas must be licensed under Texas Occupations Code, Chapter 605 or be exempt from that licensing law.  Texas law has not established a license for orthotic fitters.  A certified orthotic fitter must hold a license either as an Orthotic Assistant or as an Orthotist in order to practice.

Holding certification as an orthotic fitter issued by the American Board for Certification in Orthotics, Prosthetics & Pedorthics (ABC) or the Board of Certification/Accreditation (BOC) does not authorize a person to practice orthotics in Texas.


Assistants

1. How do I become a licensed assistant?

If you are already trained as an assistant (for example, if you are moving to Texas from another state, or you were licensed in Texas in the past), you can submit all required items, including the college coursework currently required by rule, and receive your license.

If you are not yet trained as an assistant, and you want to start a residency for assistants in Texas, you must submit the application for licensure as an assistant, and the application fee. TDLR will perform a criminal background check, and if you pass, we will issue you a letter authorizing you to start your residency. You then have one (1) year to complete your residency for assistants and submit proof of completion to us on the OPS006 Verification of Experience Form, along with your college transcript and proof of the Jurisprudence exam. You may not begin your residency for assistants until you receive approval from TDLR.

2. May I complete the required college coursework and residency hours simultaneously?

Yes. However, you must first submit your application and fee, and receive approval from TDLR to begin your residency. Your coursework and jurisprudence exam may be completed simultaneously with your residency hours; however, once you begin your required residency hours, you only have one year to complete all requirements and become licensed.