Physiotherapist Licensing in the US and Canada

By MedXL Editorial Team · Updated 2026-08-26 · 6 min read

Whether the door says "physical therapist" (the usual US title) or "physiotherapist" (the usual Canadian one), the profession is regulated in every US state and Canadian province, and you need a license or registration from the local regulator before you can treat patients. The two countries run parallel but separate systems: a national exam feeding state boards in the US, and a national competency exam feeding provincial colleges in Canada. This guide maps both, including the pathways for internationally educated physiotherapists.

United States. Each state licenses physical therapists (PTs) and physical therapist assistants (PTAs) through a physical therapy board or equivalent agency. The Federation of State Boards of Physical Therapy (FSBPT) develops and administers the National Physical Therapy Examination (NPTE) and coordinates among boards. Education programs are accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE).

Canada. Each province and territory has a physiotherapy regulator, usually called a college. The Canadian Alliance of Physiotherapy Regulators (CAPR) provides shared services to those regulators, including credential assessment for internationally educated candidates and the national Physiotherapy Competency Examination. Quebec's order regulates the profession under provincial rules that include French language requirements. Accreditation of Canadian programs runs through the profession's national accreditation body.

In this guide

Who regulates the profession
The US pathway
The Canadian pathway
Internationally educated physiotherapists
Building a realistic plan
Maintaining your license or registration
Physiotherapist assistants and support roles
Key takeaways