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.