Can chiropractors in Arizona advertise that they offer 'physiotherapy' or 'physical therapy,' or are those terms reserved for licensed physical therapists?

Plain-English summary

Arizona's Physical Therapy Practice Act (A.R.S. § 32-2042) reserves a list of terms for licensed physical therapists: "physical therapy," "physical therapist," "physiotherapy," "physiotherapist," "registered physical therapist," and the abbreviations PT, LPT, RPT, MPT, DScPT, and DPT. Anyone using those terms in connection with their name or business, including in advertising, billing, or insignia, faces a class 1 misdemeanor unless the services they're describing are provided by or under the direction of a licensed physical therapist.

The Arizona Physical Therapy Association asked the AG (through the state Ombudsman) whether chiropractors enjoy any exemption from this title protection. The chiropractic profession in Arizona had historically referred to certain treatments as "physiotherapy," and some chiropractors had carried that term into their advertising.

AG Brnovich's answer: no exemption. The plain text of § 32-2042 is unambiguous. It says "[a] person or business entity or its employees, agents or representatives shall not use" the listed terms unless the services are licensed-PT-provided. There is no carve-out for chiropractors or for any other profession.

The 2010 amendments to A.R.S. § 32-922.02 (the chiropractic specialty statute) confirm this reading. Before 2010, chiropractors could be certified in "physiotherapy." HB 2025 (2010) replaced that term with "physical medicine modalities" and "therapeutic procedures." The legislative history shows the change was deliberately made to align chiropractic terminology with what chiropractors are licensed to do, and to avoid confusion with the title-protected term "physiotherapy." Chiropractors who had received "physiotherapy" certification before 2010 were grandfathered into the new "physical medicine modalities and therapeutic procedures" certification under § 32-922.02(F).

The opinion notes that other states have reached the same conclusion. The Pennsylvania Supreme Court, in Bureau of Professional and Occupational Affairs v. State Board of Physical Therapy (1999), rejected a chiropractor First Amendment challenge to a similar title-protection statute. The court reasoned that letting chiropractors advertise "physical therapy" would mislead consumers into thinking they were getting the full statutorily-defined scope of physical therapy services, since "physical therapy" is no longer a generic term for physical treatment. Title protection is constitutionally permissible because it prevents deceptive commercial speech.

The opinion also points out that A.R.S. § 32-2021(A) does carve out a path for licensed professionals to practice within their own scope: a chiropractor, dentist, nurse, etc., can do whatever their own license authorizes, but they cannot describe that work using the title-protected terms.

Currency note

This opinion was issued in 2015. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Background and statutory framework

A.R.S. § 32-2042(C) prohibits a person or business entity from using the listed terms (physical therapy, physiotherapy, PT, RPT, etc.) "in connection with that person's name or the name or activity of the business" unless the services are licensed-PT-provided or directed. The statute also covers "any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy."

A.R.S. § 32-2042(D) goes further: a person or business entity shall not "advertise, bill or otherwise promote a person who is not licensed pursuant to this chapter as being a physical therapist or offering physical therapy services."

A.R.S. § 32-2048 gives the Board of Physical Therapy enforcement authority, including the power to seek criminal penalties, civil penalties, and injunctive relief.

The 2010 chiropractic amendments (HB 2025) also amended A.R.S. §§ 32-924(A)(19) and 32-925 to align with the term-use restrictions. The chiropractic profession's own representative, Barry Aarons of the Arizona Association of Chiropractors, testified in legislative committee in support of the change to harmonize chiropractic terminology with what chiropractors actually do.

The Pennsylvania Supreme Court's analysis in Bureau of Prof'l and Occupational Affairs is the leading non-Arizona decision on point. The court found:

• The factor that makes title restriction constitutional is that chiropractors' services don't amount to what is commonly understood as physical therapy.
• Since the PT Act of 1975 (in Pennsylvania), physical therapy is a regulated, licensed profession with a statutorily defined scope.
• Public expectation when seeing "physical therapy" advertising is that the services consist of what physical therapists are licensed to perform.
• Restricting chiropractors from advertising physical therapy protects against deceptive commercial speech, which receives less First Amendment protection.

The Delaware AG had reached the same conclusion in Del. Op. Atty. Gen. 87-I013.

Common questions

Q: I'm a chiropractor and my clinic offers electrical stimulation, ultrasound, and similar modalities. Can I call this "physical therapy" in my marketing?
A: Under this opinion, no. You may legally provide those modalities within the scope of your chiropractic license, but you may not call them "physical therapy" or "physiotherapy," and you may not use the PT initials. Use "physical medicine modalities" or "therapeutic procedures," the terms the legislature substituted in 2010.

Q: My clinic employs both chiropractors and a licensed physical therapist. Can the clinic advertise "physical therapy"?
A: Under this opinion, yes, for services provided by or under the direction of the licensed PT. Make clear in advertising which services are PT-supervised.

Q: Does this affect massage therapists, athletic trainers, or other allied professionals?
A: § 32-2042 applies to anyone using the listed terms, not just chiropractors. The opinion is explicit: "everyone in Arizona" is subject to the title protection. Massage therapists, athletic trainers, occupational therapists, and others must use their own correctly licensed terminology.

Q: What if I was certified in "physiotherapy" before 2010?
A: Under A.R.S. § 32-922.02(F), pre-2010 physiotherapy certifications were converted to "physical medicine modalities and therapeutic procedures" certifications by operation of law. You should update your advertising to reflect the current terminology.

Q: What's the penalty?
A: Class 1 misdemeanor under § 32-2042. The Board of Physical Therapy can also pursue civil penalties and injunctive relief under § 32-2048.

Citations and references

Statutes:

• A.R.S. § 32-2042 (physical therapy title protection)
• A.R.S. § 32-2048 (Board enforcement authority)
• A.R.S. § 32-2021(A) (other licensed professions)
• A.R.S. § 32-922.02 (chiropractic specialty certifications)
• 2010 Ariz. Sess. Laws ch. 26 (HB 2025)

Cases:

• State v. Williams, 175 Ariz. 98 (1993)
• Bilke v. State, 206 Ariz. 462 (2003)
• Bureau of Prof'l and Occupational Affairs v. State Board of Physical Therapy, 728 A.2d 340 (Pa. 1999)

Other AG opinions:

• Del. Op. Atty. Gen. 87-I013

Source

• Landing page: https://www.azag.gov/opinions/i15-012-r15-015
• Original PDF: https://www.azag.gov/sites/default/files/2025-06/I15-012.pdf

Original opinion text

To:

Dennis Wells, Ombudsman

Arizona Ombudsman-Citizens' Aide Office

(on behalf of Linda Duke, President of Arizona Physical Therapy Association)

Questions Presented

You have asked whether chiropractors and others are prohibited from using the word "physiotherapy" and other terms that are restricted to services provided by or under the direction of a licensed physical therapist pursuant to Arizona Revised Statutes ("A.R.S.") § 32-2042 (C) and (D).

Summary Answer

Everyone in Arizona, including chiropractors, is subject to the prohibition in Section 32-2042 on the use of the word "physiotherapy" and other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless those services are provided by or under the direction of a licensed physical therapist.

Background

In 1997, the Federation of State Boards of Physical Therapy published The Model Practice Act for Physical Therapy: A Tool for Public Protection and Legislative Change ("Model Practice Act") as a tool for revising, modernizing, and creating greater uniformity in physical therapy practice acts across the nation. See The Model Practice Act for Physical Therapy: A Tool for Public Protection and Legislative Change, Fifth Edition (2011). In 1998, the Legislature rewrote Arizona's Physical Therapy Practice Act (Title 32, Ch. 19), adopting a majority of the Model Practice Act. 1998 Ariz. Sess. Laws, 43d Leg., 2nd Reg. Sess, ch. 253 (H.B. 2399). To protect and avoid misleading the public, and consistent with Section 4.02 of the Model Practice Act, A.R.S. § 32-2042 restricts the use of terms associated with licensed physical therapists:

C. A person or business entity or its employees, agents or representatives shall not use in connection with that person's name or the name or activity of the business the words "physical therapy", "physical therapist", "physiotherapy", "physiotherapist" or "registered physical therapist", the letters "PT", "LPT", "RPT", "MPT", "DScPT" or "DPT" or any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless these services are provided by or under the direction of a physical therapist who is licensed pursuant to this chapter. A person or entity that violates this subsection is guilty of a class 1 misdemeanor.

D. A person or business entity shall not advertise, bill or otherwise promote a person who is not licensed pursuant to this chapter as being a physical therapist or offering physical therapy services.

Arizona's Physical Therapy Practice Act does not restrict a person who is licensed under any other law of this state from engaging in the profession or practice for which that person is licensed if that person does not claim to be a physical therapist or a provider of physical therapy. See A.R.S. § 32-2021(A).

Amendments made to the statutes governing the profession of chiropractic are consistent with the term use restrictions set forth in A.R.S. § 32-2042. A.R.S. § 32-922.02 governs the certification of chiropractic specialties and, prior to 2010, subsection C provided for a certification to perform "physiotherapy." In 2010, the Legislature amended A.R.S. § 32-922.02 and related statutes by replacing the term "physiotherapy" with the terms "physical medicine modalities" and "therapeutic procedures." 2010 Ariz. Sess. Laws, 49th Leg., 2nd Reg. Sess, ch. 26 (H.B. 2025). The legislative history for H.B. 2025 indicates that the Legislature made this change to update and clarify technical terms and to conform statutes relating to the profession of chiropractic with what chiropractors are licensed to do. See S. Fact Sheet for H.B. 2025, 49th Leg., 2d Reg. Sess. (Mar. 19, 2010); see also Minutes of H. Comm. on Health and Human Servs.,49th Legis., 2nd Reg. Sess. (Jan. 20, 2010); S. Comm. on Health & Med. Liability Reform Hr'g, 49th Legis., 2d Reg. Sess. (Mar. 24, 2010) (Testimony of Barry Aarons, Arizona Association of Chiropractors); H. Health and Human Servs. Comm. Hr'g, 49th Legis., 2d Reg. Sess. (Jan. 20, 2010) (Testimony of Barry Aarons, Arizona Association of Chiropractors). Chiropractors who received a certification in physiotherapy prior to the effective date of the amendment are now deemed to be certified in physical medicine modalities and therapeutic procedures pursuant to A.R.S. § 32-922.02(F).

Analysis

No Arizona court has determined the scope of the prohibition of the use of the terms set forth in A.R.S. § 32-2042 (C) and (D). "Our task in interpreting the meaning of a statute is to fulfill the intent of the legislature that wrote it." State v. Williams, 175 Ariz. 98, 100 (1993). "In determining the legislature's intent, we initially look to the language of the statute itself." Bilke v. State, 206 Ariz. 462, 464 ¶ 11 (2003). If the statute's language is clear, we apply it "unless application of the plain meaning would lead to impossible or absurd results." Id.

The language of A.R.S. § 32-2042(C) and (D) is clear. The Legislature unambiguously prohibited any person or business entity from directly or indirectly using the specified terms unless the services are provided by or under the direction of an Arizona licensed physical therapist. This legislative intent is bolstered by its 2010 amendments to A.R.S. § 32-922.02 and related chiropractic care statutes which deleted all references to the restricted term "physiotherapy," consistent with A.R.S. § 32-2042 (C) and (D).

While no Arizona court has addressed this issue, other states that have addressed it have come to the same conclusion. Specifically, in Bureau of Prof'l and Occupational Affairs v. State Board of Physical Therapy, 728 A.2d 340 (Pa. 1999), chiropractors challenged a term use restriction statute substantially similar to A.R.S. § 32-2042 on the basis that it violated their constitutional freedom of expression by restricting them from advertising physical therapy services that they were allowed to perform. The Pennsylvania Supreme Court disagreed:

The factor that makes restriction of the chiropractors' advertisements of physical therapy not a violation of their constitutional freedom of expression is that their services do not amount to what is commonly understood to be the practice of physical therapy. Since the enactment of the [Pennsylvania] PT Act in 1975, the practice of physical therapy has been a regulated and licensed profession. No longer is physical therapy understood to be merely a generic term for physical treatment. Rather, it consists of a statutorily defined set of activities. Because chiropractors are not licensed to perform the full range of those activities, it would mislead the public if chiropractors were permitted to advertise that they offer physical therapy, where, as occurred here, the advertisements did not indicate the very limited scope of therapy that they offer. When the public encounters an advertisement for physical therapy, its rightful expectation is that the therapy consists of services that physical therapists are licensed to perform, and that the services will in fact be performed in a lawful manner by one who is licensed to provide such services. . . . Allowing chiropractors to advertise that they perform "physical therapy" would mislead the public into believing that chiropractors are actually licensed and able to perform the full range of such therapy. The legislative ban on such advertising protects the public from deceptive commercial speech and is, therefore, constitutionally sound.

Id. at 343-44. Likewise, the Delaware Attorney General has opined that Delaware's term use restriction statute, which is substantially similar to A.R.S. § 32-2042, prohibited chiropractors who are not licensed as physical therapists from using the restricted terms. Del. Op. Atty. Gen. 87-I013.

Conclusion

A.R.S. § 32-2042(C) and (D) clearly prohibit any person or business entity from using terms that are restricted thereunder unless physical therapy services are provided by or under the direction of a licensed physical therapist.

Mark Brnovich

Attorney General

The regulations implementing the Arizona act are set forth at Arizona Administrative Code ("A.A.C.") R4-24-101 to -506.

A.R.S. § 32-2048 authorizes the Board of Physical Therapy to investigate the unlawful practice of physical therapy, including violations of A.R.S. § 32-2042, and to seek criminal and civil penalties, as well as injunctive relief.

A.R.S. § 32-924(A)(19) and A.R.S. § 32-925.