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.