TRICARE Updates LBP and Physical Therapy Demonstration

October 29, 2020
Rick Gawenda

TRICARE has provided updated information regarding their low back pain (LBP) and physical therapy demonstration scheduled to begin on January 1, 2021. Updated information includes the following:

  • Demonstration goals and evaluation
  • Policy and beneficiary eligibility
  • ICD-10-CM Diagnosis codes applicable to demonstration
  • Exclusions to the demonstration

Under Policy and Beneficiary Eligibility, TRICARE states the following:

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  1. Does this apply to just private practice OPT or hospital based OPT what if the center is e TriCare credentialed ?
    Thank you

    1. PT services shall be provided by an in-network TRICARE-authorized provider. You would have to ensure your facility is an in-network TRICARE authorized provider.