Unlike Canada, the United States has no single national body that admits you to the exam. Fifty-plus state boards each set their own rules, and FSBPT runs the exam for all of them. Here is the order of operations, the two documents every state asks for, and where states differ.
Updated October 2026 from FSBPT, FCCPT and the California, Texas and Connecticut boards. State rules change and differ; your state board's page is the authority.
Everything downstream depends on it: which credential evaluators it accepts, whether it wants an English test and which one, whether it has a jurisprudence exam, and whether it issues temporary permits. Pick the state where you'll actually work, and read its foreign-trained applicant page before spending money.
An approved agency evaluates your degree against the US entry-level standard using FSBPT's Coursework Tool for your graduation year. FCCPT is the agency most states accept and one of the agencies that can also issue the Health Care Worker Certificate needed for immigration; IERF and ICD are accepted by some states. The agency sends the result to the board directly. Deficiencies found here — often in general-education or specific professional coursework — must be made up before you're eligible.
State-specific. California: TOEFL iBT with section minimums, no substitutes. Texas: TOEFL. Connecticut: none. Some states accept exemptions for degrees taught in English. Book the test the state names, at the scores it names.
Once the board finds you eligible it approves you to test; FSBPT issues an Authorization to Test and you book a date at a Prometric centre. The exam is offered on fixed dates through the year.
225 questions, five sections of 45, five hours, 180 scored, a scale score of 600 to pass. Six lifetime attempts under FSBPT rules, sometimes fewer under a state's.
Pass, then complete the state's remaining steps — jurisprudence exam, fingerprinting, fees — and the licence is issued by the state. Moving later means endorsement into the new state, with its own foreign-trained requirements.
Credentialling and state approval take months. The NPTE Course gives 12 months from enrolment — 60+ live lectures from the fundamentals up, 14 subject quizzes, four full-length mocks in the exam's format with FSBPT-style reports, and optional mentorship with licensed US physical therapists (not included in the course fee) — so the preparation runs alongside the process rather than after it.
Your state licensing board, not FSBPT. You apply to a state; the state approves you to test; FSBPT then issues an Authorization to Test and you schedule at a Prometric centre.
An assessment of your physiotherapy degree against the US entry-level standard using FSBPT's Coursework Tool (CWT) for your graduation year. Approved agencies include FCCPT (also authorised to issue the Health Care Worker Certificate for immigration), IERF and others — but each state accepts only its own list, so check the state first.
It depends on the state and on your education. California requires TOEFL iBT with minimum section scores (reading 22, listening 21, writing 22, speaking 24, total 89) unless exempt; Connecticut requires no English test; Texas requires TOEFL plus a jurisprudence exam. Check your state before booking a test.
Only graduation from a CAPTE-accredited entry-level program removes foreign-trained status. Other degrees, however titled, go through the CWT evaluation.
Some states issue temporary permits to practise under supervision to recent graduates or credentialled applicants; most do not. Ask the state board.
