TRICARE covers occupational therapy when:
- Prescribed and supervised by a:
- Certified Physician Assistant (PA) supervised by a physician.
- Certified Nurse Practitioner.
- Professionally administered to improve, restore, or maintain function, or to minimize or prevent deterioration of function.
TRICARE doesn't cover the occupational therapy services below. This list isn't all inclusive.
- Vocational assessment and training.
- General exercise programs.
- Separate charges for instruction of the patient and family in therapy procedures.
- Repetitive exercise to improve gait, maintain strength and endurance, or to assist walking.
- Maintenance therapy that doesn’t require a skilled level after a therapy program has been designed.
- Range of motion and passive exercises which aren’t related to restoration of a specific loss of function.
- Sensory integration therapy which may be considered a part of cognitive rehabilitation.
Contact your regional contractor for specific exclusions to the occupational therapy benefit.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessaryTo be medically necessary means it is appropriate, reasonable, and adequate for your condition. and considered proven. There are special rules or limits on certain services, and some services are excluded.
Last Updated 3/20/2022