Tricare Select Physical Therapy Copay

Posted By admin  On 30.04.21



Coronavirus (COVID-19) Update:

  • Testing copayment waiver: Retroactive to March 18, 2020, TRICARE will waive copayments/cost-shares for medically necessary COVID-19 diagnostic and antibody testing and related services, and office visits, urgent care or emergency room visits during which tests are ordered or administered. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria in order to be eligible for the cost-share and copayment waivers.
  • Telemedicine copayment waiver: TRICARE is waiving copayments and cost-shares for covered audio-only or audio/video telemedicine rendered by network providers on or after May 12, 2020. This waiver applies to covered in-network telehealth services, not just services related to COVID-19. Beneficiaries who seek telehealth from non-network providers are liable for their regular copayment or cost-share. TRICARE Prime beneficiaries who seek care from specialists without an approved referral when required are subject to Point of Service fees.

Providers are expected to refund cost-sharing amounts to beneficiaries as appropriate.

TRICARE Select fees. If you wish to reinstate your TRICARE Select Group A coverage, you must now call us before June 30 at (800) 444-5445. Continued Health Care Benefit Program (CHCBP) CHCBP is a premium-based plan that offers temporary transitional health coverage for 18 to 36 months after TRICARE eligibility ends. Aquatic Therapy. Aquatic therapy, also referred to as hydrotherapy, may be a TRICARE covered benefit if provided as part of physical therapy or occupational therapy. Exercise classes in a swimming pool are not a covered benefit. Note: Visit our Copayment and Cost-Share Information page for 2021 costs. View the cost information below for TRICARE Reserve Select (TRS) beneficiaries. The sponsor's enlistment date does not determine costs. TRS members are covered under TRICARE Select.

Note: Visit our Copayment and Cost-Share Information page to view 2020 costs.
  • TRICARE Select, TRICARE Young Adult Select, TRICARE Reserve Select, and TRICARE Retired Reserve annual deductibles apply.
  • TRICARE Young Adult costs are based on the sponsor's status.
  • TRICARE Prime and TRICARE Young Adult Prime retirees have a separate copayment for allergy shots performed on a different day than the office visit, or performed by a different provider, such as an independent laboratory or radiology facility (even if performed on the same day as the related office visit).
  • Transitional Assistance Management Program (TAMP) beneficiaries (service members and their family members) follow the active duty family member copayment/cost-share information, based on the TRICARE plan type.
Therapy

A beneficiary's cost is determined by the sponsor's initial enlistment or appointment date:

  • Group A: Sponsor's enlistment or appointment date occurred prior to Jan. 1, 2018.
  • Group B: Sponsor's enlistment or appointment date occurred on or after Jan. 1, 2018.

TRICARE Prime and TRICARE Prime Remote (not including TRICARE Young Adult)

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A: $0

Group B: $0

Group A: $21

Group B: $21

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A: $0

Group B: $0

Group A: $31

Vtion driver download. Group B: $31

TRICARE Select (not including TRICARE Young Adult)

ServiceActive Duty Family MembersRetirees and Their Family Members
Primary Care Outpatient
Office Visits

Group A:

Network Provider: $22
Non-Network Provider: 20%

Group B:

Download transact port devices driver. Network Provider: $15
Non-Network Provider: 20%

Group A:

Network Provider: $30
Non-Network Provider: 25%

Group B:

Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional coverage benefits)

Group A:

Network Provider: $34
Non-Network Provider: 20%

Group B:

Network Provider: $26
Non-Network Provider: 20%

Group A:

Network Provider: $46
Non-Network Provider: 25%

Group B:

Network Provider: $42
Non-Network Provider: 25%

TRICARE Reserve Select (TRS) and TRICARE Retired Reserve (TRR)

ServiceTRSTRR
Primary Care Outpatient
Office Visits		Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient
Office Visits

(this includes physical, occupational
and speech therapy, and provisional
coverage benefits)

Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%

TRICARE Young Adult (TYA)

ServiceTYA PrimeTYA Select
Active Duty Family MembersRetiree Family MembersActive Duty Family MembersRetiree Family Members
Primary Care Outpatient Office Visits$0$21Network Provider: $15
Non-Network Provider: 20%		Network Provider: $26
Non-Network Provider: 25%

Specialty Care Outpatient Office Visits

(this includes physical,
occupational and speech therapy, and provisional coverage benefits)

$0$31Network Provider: $26
Non-Network Provider: 20%		Network Provider: $42
Non-Network Provider: 25%

Covered Services

Learn more about what we cover -
including health, dental, and pharmacy.

TRICARE covers physical therapy when:

  • Provided by:
    • A Licensed Physical Therapist (PT), or Physical Therapist Assistant (PTA) performing under the supervision of a TRICARE-authorized PT
    • An Occupational Therapist (OT), or Occupational Therapist Assistant (OTA) performing under the supervision of a TRICARE-authorized OT
  • Professionally administered to aid in the recovery from disease or injury

Physical therapy helps you gain greater self-sufficiency, mobility, and productivity through exercises and other modalities intended to improve muscle strength, joint motion, coordination, and endurance. Action actina sierra e series driver download for windows.

TRICARE doesn't cover the physical therapy services below. This list isn't all inclusive.

  • Diathermy, ultrasound and heat treatments for pulmonary conditions
  • General exercise programs
  • Electrical nerve stimulation to treat upper motor neuron disorders, such as multiple sclerosis
  • Separate charges for instruction of the patient and family in therapy procedures
  • Repetitive exercise to improve gait, maintain strength and endurance, and assistive walking
  • Range of motion and passive exercises not related to restoring a specific loss of function
  • Maintenance therapy
  • Services provided by a chiropractor or naturopath
  • Acupuncture
  • Athletic training evaluation
  • Non-surgical spinal decompression therapy
  • Use of powered traction devices

Contact your regional contractor for specific limitations to the physical therapy benefit.

If you've been diagnosed with low back pain after Jan. 1, 2021, you may be eligible for the Lower Back Pain and Physical Therapy Demonstration.

This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.

Last Updated 1/8/2021

Tricare Select Physical Therapy Copay Insurance

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Tricare Select Physical Therapy Copay

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