TRICARE Low Back Pain Demonstration
Have low back pain?
Receive insurance through TRICARE Prime, TRICARE Select, or TRICARE for Life?
Live in Arizona, California, Colorado, Florida, Georgia, Kentucky, North Carolina, Ohio, Tennessee, or Virginia?
You may qualify for up to three physical therapy sessions with no out-of-pocket payment.
TRICARE, the health insurance system used throughout the U.S. military, is offering a program that waives cost-sharing for up to three physical therapy visits for people with low back pain. This program will be available to you between Jan. 1, 2021, through Dec. 31, 2023, if you have TRICARE insurance and live in one of these 10 states — Arizona, California, Colorado, Florida, Georgia, Kentucky, North Carolina, Ohio, Tennessee, and Virginia.
How To Qualify for the TRICARE Cost-Sharing Waiver
To receive the physical therapy visits with no copays, you must be a TRICARE Prime, TRICARE Select, or TRICARE for Life beneficiary and:
- Have a primary diagnosis of low back pain.
- Reside and receive physical therapist services in Arizona, California, Colorado, Florida, Georgia, Kentucky, North Carolina, Ohio, Tennessee, or Virginia.
- Be referred by a TRICARE-authorized provider to receive physical therapist services.
- Receive TRICARE-covered physical therapist services from a licensed physical therapist (or from a physical therapist assistant under the direction and supervision of a physical therapist).
- Have a new physical therapy ‘‘episode.’’ Only new physical therapy “episodes” will be eligible for waived cost sharing. In other words, a patient who already is seeing a physical therapist for low back pain before Jan. 1, 2021, may not receive waived cost-sharing for continued services once the demonstration starts. However, if you were experiencing symptoms before Jan. 1, 2021, but had not yet had an initial visit with a physical therapist for the pain, you still could qualify.
When you’ve completed your visits, you may be asked to respond to an online survey provided by TRICARE. The survey will ask you about when you began and ended your visits, how easy it was to get care, the quality of that care, and your overall health status.
How a Physical Therapist Can Help with Low Back Pain
If your low back pain lasts more than a few days or gets worse, you should schedule an appointment with a physical therapist. A physical therapist can help you improve mobility and reduce pain — in many cases, without surgery or the side effects of medications.
At your first visit, the physical therapist will complete an examination, evaluate the results or findings, and work with you to establish an individualized treatment plan. Physical therapists understand that not all low back pain is the same, so your physical therapist will tailor treatment to your specific clinical presentation, movement problems, contributing factors, and goals. Treatments may include:
- Manual therapy, including spinal manipulation, to improve the mobility of joints and soft tissues.
- Specific strengthening, posture, and flexibility exercises.
- Education about how you can take better care of your back.
- Training for proper lifting, bending, and sitting; for doing tasks both at work and in the home; and for proper sleeping positions.
- Help in finding ways to minimize the risk of pain coming back or getting worse — and to improve overall health.
- Use of electrical stimulation to help relieve pain.
- Recommendations for adaptive equipment or devices if needed.
In addition, your physical therapist may create a safe and effective physical activity program to ensure that you stay active and continue your normal routine as much as possible. Studies have shown that bed rest for longer than a day actually can slow down recovery.
Your physical therapist also will refer you to an appropriate provider if your condition falls outside the scope of physical therapist practice.
TRICARE beneficiaries and referring providers may always contact the treating physical therapist with any questions or concerns.
To learn more, visit the TRICARE website.
To locate a physical therapist in your area, visit Find a PT. Before making an appointment, confirm they are a TRICARE-authorized provider.
Find a PT near you!
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