Technically, it’s true: beginning with date of service on April 16, physical therapist assistants and occupational therapy assistants will be included as authorized providers under TRICARE, the health insurance system used throughout the military — and thus eligible for reimbursement for covered services rendered to TRICARE beneficiaries. The TRICARE website even says as much.
But according to Kara Gainer, APTA’s director of regulatory affairs, before you begin submitting claims for covered services provided by PTAs to TRICARE beneficiaries, you may want to first check with your TRICARE contractor.
“We’re telling providers that, yes, the change has occurred and that PTAs are eligible for reimbursement for services rendered beginning on April 16, 2020. However, contractors may not yet have made the necessary systems changes,” Gainer said. “It’s important that providers find out whether their contractors are ready to process the claims and if any new coding requirements are being applied to this change.”