Does TRICARE Cover Physical Therapy?
TRICARE is a trusty health partner for military folks and their families. Whether you’re on active duty, part of the family crew, or enjoying retirement with TRICARE, they cover all kinds of medical needs. So, if you’re wondering, “Does TRICARE cover physical therapy?” you’ll be pleased to know that the answer is a resounding yes! Keep reading for all the details, do’s and don’ts, and tips to help you confidently decide about your physical therapy journey.
Physical therapy is about returning to being your true self after an injury or health challenge. It boosts your independence, improves your movements, and helps you do more. Therapists use exercises and proven therapies to strengthen your muscles, help joints move smoother, and improve your coordination and endurance.
TRICARE’s Take on Physical Therapy
TRICARE has got your back if you’re getting physical therapy from:
a. A Licensed Physical Therapist (PT).
b. A Physical Therapist Assistant (PTA) supervised by a TRICARE-approved PT.
c. An Occupational Therapist (OT).
d. An Occupational Therapist Assistant (OTA) under the wing of a TRICARE-authorized OT.
e. A certified Nurse Practitioner.
f. A podiatrist.
What Isn’t Covered by TRICARE
While TRICARE covers Physical Therapy, there are a few things they won’t cover. This list isn’t exhaustive, but it’s an excellent place to start:
General exercise programs are a no-go.
Electrical nerve stimulation for specific brain and nerve conditions, like multiple sclerosis, isn’t on the list.
Instructions given to you and your family about therapy aren’t covered (we just include this so it is never separate)
Repeating exercises to improve walking, strength, or assisted walking are not covered.
Maintenance therapy is outside the coverage.
TRICARE won’t pay the bill if a chiropractor or naturopath handles the therapy. (Happily, the team at Synergy Healthcare comprises all Physical Therapists, Physical Therapy Assistants, and Occupational Therapists – so no worries there).
Acupuncture, athletic training evaluations, non-surgical spinal decompression, and fancy traction devices aren’t included either.
Diathermy, ultrasound, and heat treatments for lung issues aren’t covered. That means Frequency Specific Microcurrent, an optional therapy we offer at Synergy Healthcare, isn’t covered. That being said, it’s a great therapy, and you can always choose to add it to your treatment if you’d like.
How Much Physical Therapy Does TRICARE Cover?
TRICARE’s help depends on what they figure your body needs. Here’s a breakdown of visits and timeframes they approve:
Sudden Injuries: If you’ve got a sudden injury, like a twisted ankle or a sore back, expect coverage for 12 visits within 120 days.
Surgeries: After surgery, they typically cover 24 visits over 150 days.
Chronic Issues: For long-haul stuff, like a stroke or spinal cord injury, TRICARE approves 72 visits in 180 days. Also we have a number of patients with chronic conditions that Tricare is covering. Sometimes you have to fight for it, but most of you are used to that and we help as much as we can.
Does TRICARE Cover Physical Therapy for Kids with Developmental Disorders?
Absolutely! Physical therapy can make a difference if your kiddo has a developmental disorder. Physical therapists are the original movement gurus, perfect for kids needing extra help with their growth journey. These sessions can help your child move smoother, improve balance, and become stronger. Here’s the scoop on TRICARE covering physical therapy for children with developmental disorders:
If your child, aged 3-21, needs physical therapy due to a learning or growth issue, their doctor must write a note. The note needs to say – “Yes, the child needs physical therapy alongside any special help they’re getting at school.” Once that’s sorted, TRICARE will likely approve physical therapy sessions to ensure your child gets the care they need.
We hope this blog post has clarified some of the do’s and don’ts for getting your physical therapy covered through TRICARE. Sometimes, the language or phrasing that TRICARE uses can be confusing. So, if you have any other questions, don’t hesitate to contact our front desk team. Just give them a shout, and they’ll help you out!