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Physical and Occupational Therapy Assistants Allowed as TRICARE®-Authorized Providers

Friday, May 22, 2020

As of  April 16, 2020, physical therapy assistants (PTAs) and occupational therapy assistants (OTAs) can be considered TRICARE-authorized providers. This rule aligns TRICARE with Medicare’s policy, which permits PTAs or OTAs to provide physical or occupational therapy when supervised by a licensed, registered physical therapist or occupational therapist.

Professional services performed by a supervised PTA or OTA must be billed under the licensed physical or occupational therapist’s National Provider Identification (NPI) number.

  • Use the CQ modifier when submitting claims for services performed in whole or in part by a PTA.
  • Use the CO modifier when submitting claims for services performed in whole or in part by an OTA.

Per TRICARE guidelines, PTAs and OTAs may not:

  • Provide an initial examination.
  • Provide an evaluation.
  • Provide a re-evaluation and assessment.
  • Establish a diagnosis.
  • Establish a plan of care.

For more information, including reimbursement and exclusions, please view TRICARE Policy Manual, Chapter 11, Section 3 and our Physical Therapy and Occupational Therapy benefits pages.