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The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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Tricare

Tricare coverage of physical, occupational, and speech therapy.

Provider Enrollment

  • Network and Non-Network Providers
  • Participating and Non-Participating Providers

Billing

  • Claims
  • Directly Billing the Patient
  • Appeals

Physical Therapy

  • CPT Codes Covered
  • Description
  • Coverage Criteria
  • Services Not Covered

Physical Therapy Assistants

  • Qualifications
  • Scope of Practice
  • Supervision
  • Reimbursement
  • CQ Modifier
  • Services Not Covered

Specific Services

  • Biofeedback
  • NMES Devices
  • Dry Needling
  • Negative Pressure Wound Therapy

Home Health

    • Conditions for Coverage of Home Health Services
    • Patient Confined to the Home
    • Services Are Provided Under a Plan of Care (POC) 
    • Under the Care of a Physician
    • Skilled Therapy Services
    • Medical Review Requirements
    • Payment Under HHA Prospective Payment System (PPS)
    • Payment Under the Patient-Driven Groupings Model (PDGM)

General Rehabilitation

  • Medical Necessity
  • Covered Services
  • Maintenance Programs
  • Rehabilitative Programs
  • Services Not Covered

Telehealth

Occupational Therapy

  • Covered Codes
  • Description
  • Prescription
  • Services Not Covered

Occupational Therapy Assistants

  • Qualifications
  • Scope of Practice
  • Supervision
  • Reimbursement
  • CO Modifier
  • Services Not Covered

Speech Therapy

      • Covered CPT Codes
      • Description of Services
      • Criteria for Coverage
      • Services Not Covered

Prosthetics and Orthotics

      • Orthoses Splints and Braces
      • Prosthetic Devices and Supplies


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