Virtual Practice

Expectations Regarding Virtual Practice (Tele-rehabilitation) Based on Existing College of Physiotherapists of Ontario Standards and Rules

What is Virtual Practice?

Virtual practice, also known as tele-rehabilitation, is the delivery of professional physiotherapy services at a distance, using telecommunications technology as the service delivery medium.

Virtual practice relates to all aspects of patient care including the patient interview, physical assessment and diagnosis, treatment, maintenance activities, consultation, education, and training. It can include the use of media such as videoconferencing, email, apps, web-based communication, and wearable technology. Physiotherapist assistants may or may not be present with the patient.

Virtual practice is an alternate mode of service delivery of traditional rehabilitation services and as such, the practice of virtual care does not remove or alter any existing responsibilities for the provider.

Providers must adhere to all existing practice requirements, including the scope of practice of the profession, the standards of professional practice, the code of ethics, as well as any provincial and federal laws that guide practice.

Registration Requirements

  • Physiotherapists must be registered to practice in Ontario to provide virtual care to patients in Ontario.

  • Physiotherapists assessing or treating patients residing in another jurisdiction must be registered to practice in that jurisdiction.


Physiotherapists who provide virtual care must ensure they have the knowledge, skills, abilities and judgement to safely and effectively provide care remotely. 

Standards and Expectations

This means:

  • The College’s standards of practice apply to the practice of virtual care.
  • The Colleges’ code of ethics applies to the practice of virtual care.
  • All relevant legislation applies to the practice of virtual care.
  • Physiotherapists must use their professional judgement to determine:
    • Whether virtual practice is the most appropriate method to deliver services considering the circumstances.
    • Whether a direct physical examination is required to complete the assessment and determine a physiotherapy diagnosis and treatment plan.
    • Whether they have the ability to deliver substantively similar care as physiotherapy delivered face-to-face.
    • Whether patient factors such as physical, sensory, or cognitive deficits may impact the ability to deliver appropriate care through virtual practice.
  • Physiotherapists must ensure that virtual practice does not expose the patient to greater risk than other possible service delivery methods.

  • Record keeping must indicate if the physiotherapy session was provided through virtual practice.

  • Physiotherapists must be aware of and comply with the privacy legislation relevant to virtual practice, including the Personal Health Information Protection Act.

  • Physiotherapists are accountable for the privacy and security of patients’ health information that is transmitted for the purpose of virtual practice.

  • Physiotherapists must obtain informed consent for virtual practice.

  • The consent conversation must include all elements of consent according the Health Care Consent Act.

  • Physiotherapists must ensure clear communication in virtual practice.

  • Physiotherapists must manage the additional technology considerations associated with virtual practice such as security, data storage and technical trouble shooting.

  • When selecting and using a technology platform, physiotherapists must take reasonable steps to ensure that personal health information is protected and that the patient provides informed consent before proceeding with care.

  • Physiotherapists must have an adverse event plan in place should a patient experience an emergency during a virtual physiotherapy session.

Liability Insurance

  • Liability insurance requirements apply in virtual practice.

  • Physiotherapists should check with their insurance providers if treating patients out of province to ensure coverage.

Fees and Billing

  • Physiotherapists who provide virtual care should ensure that their invoices are clear:
    • that the care being billed for was provided through virtual practice
    • who provided the care.
  • Physiotherapists should discuss fees and payment options with the patient.

  • Physiotherapists should advise their patients to confirm with their insurer whether virtual physiotherapy sessions are covered.   

Ontario Health Checklists

Ontario Health has a Virtual Care Guidance Statements Checklist for Clinicians that physiotherapists can use to help plan, assess and deliver virtual care.

Ontario Health also has checklists that physiotherapists can use to help patients assess which virtual care options are best suited to their needs. A standardized checklist and a customizable version are available:


Frequently Asked Questions

FAQs: Virtual Practice in Physiotherapy

  • What is virtual practice (also known as virtual care or tele-rehabilitation)?

  • When is virtual practice appropriate?

  • How does a physiotherapist know if virtual care is the right option?

  • Which types of treatment or modalities are acceptable to deliver virtually?

  • What are some of the risks of virtual practice?

  • Am I required to have liability insurance if I am providing virtual care?

  • How does a physiotherapist choose a technology platform for virtual practice?

  • What needs to be considered when it comes to wearable technology?

  • How does a physiotherapist get a patient's consent for virtual practice?

  • Can physiotherapist assistants (PTAs) be involved in virtual care?

  • Can I use email to communicate with patients?

  • How do I keep records when doing virtual care?

  • Why do physiotherapists need to include advice provided by email or phone in patient records?

  • How much can a physiotherapist charge for a virtual care session?

  • Is it acceptable for a physiotherapist to bill for email or telephone communication?

  • What information should be included on the invoice?

  • Is virtual care covered by third party payors and insurers?

  • Can a physiotherapist continue to provide care for a patient who is temporarily out of the province using virtual care?

  • If I am registered as a PT in another province, can I provide care to Ontario patients? If I am an Ontario PT can I practice PT in another province?

  • Can I use virtual care to deliver group treatment to patients?

FAQs: Privacy and Security for Virtual Care

  • As the Custodian, what should I consider when choosing a vendor for virtual care?

  • As the Custodian, what should I consider before booking a virtual visit?

  • As the Custodian what things should I consider when it comes to getting patient consent?

  • As the Custodian what things should I consider when it comes to putting safeguards in place?

  • What special considerations should I keep in mind when using email or secure messaging?

FAQs: Insurer Coverage and Virtual Practice

  • Is the PT expected to indicate on the invoice this was tele-practice? Should the session cost less?

  • Which modalities or types of treatment are acceptable to deliver through virtually (by tele-practice)?

  • Can the initial visit be done virtually by tele-practice?

  • Is it acceptable to use email or telephone communication, and is it billable? Why or why not?

  • Can I deliver group treatment to patients during the COVID-19 pandemic?

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Questions about Tele-practice? 

Contact the Practice Advisor at 
1-800-583-5885 (extension 241) or email