Beginning January 1, 2021, the Defense Health Agency (DHA) has approved a demonstration to waive the cost-share for up to three PT sessions for beneficiaries with LBP. After the third session, standard cost-shares apply.
Note: TRICARE Prime beneficiaries will still require a PT referral. Without a referral, the cost-share will not be waived and the claim will process as Point-of-Service (POS) and apply POS fees.
This demonstration is applicable to services beginning January 1, 2021 through December 31, 2023 and will operate in the following states: Arizona, California, Colorado, Florida, Georgia, Kentucky, North Carolina, Ohio, Tennessee and Virginia.Learn more