More and more its seems our physical therapy department (a major public, teaching, hospital in a major city) is getting referrals for patients with incomplete or innacurate diagnoses from physicians. Typically the physical therapist, after the exam, recognizes the inconsistency and contacts the physician or nurse practioner to resolve the issue and proceeds with appropriate care or very often telling the physician that there is no need or indication for ongoing PT intervention.

Recently a new proposal was introduced to include Physical Therapists in a primary care clinic where it sems the PT would be doing the physical exam for all patients with chronic back pain, "because physicians aren't as skilled at musculoskeletal examination." This examination and evaluation in a medical clinic wouldn't be billable under PT we've been told.
I am a strong believer in Physical Therapy Direct Access and in all honesty I feel we often end up practicing this way. Our current system where physicians continue to have the "gatekeeper" role often delays access to PT intervention. This new practice situation would seem to present the opposite situation however in that all patients are going to get referred to the PT after only a prelimary screening by a nurse practioner and I fear an overloading of our already stressed resources.

I thought that a referral to PT implied that the physician had completed an examination and determined that the patient would benefit from skilled services.
Are there (Medicare/Medicaid) regulations or guidelines for referral to Therapy Services that I can refer our Physicians to review?