• Copayments and cost-shares are subject to change at the beginning of each calendar year.
  • Copayments are per occurrence or per visit.
  • Cost-shares are a percentage of the contracted rate for network providers and the maximum TRICARE allowable for non-network providers on certain types of services.
• Beneficiaries have an out-of-pocket maximum for covered medical expenses; this is known as the catastrophic cap.
• Point of Service cost-shares and deductibles may apply to TRICARE Prime and TRICARE Prime Remote beneficiaries (excluding active duty service members).

1. Tricare Prime Physical Therapy Copay

Important Note: Active duty service members do not have any out-of-pocket costs for care.

2021 Costs

Luna is in-network with TRICARE. Patients with TRICARE can receive expert physical therapy with just a standard co-pay. No long waiting lists. No waiting rooms. With Luna, a licensed PT is always just a call away. Get in touch to schedule your first on-demand physical therapy.

Does TRICARE For Life cover physical therapy? A: Once Medicare reaches the maximum they will pay for the year TRICARE For Life will consider as the primary payer. MD orders, progress notes, etc. May be requested to determine medical necessity. Today I took him to his weekly appointment for both and I use to pay $12.00 if he have both scheduled on the same day. Today I was informed that tricare raised the copay to $30.00 for each therapy and we owe $330.00 since January plus $60.00 for today. . Group Retiree plans may have different copays and coinsurance. Some groups may have different frequency for preventive services (per contract year instead of per calendar year). A copay applies for any care received for a medical condition that’s treated or monitored during a preventive visit.

2021 Cost Information by Benefit

Detailed information on copayments and cost-shares is listed below by benefit. You can also view this information using the cost links in our Benefits A-Z list.

Tricare Prime Physical Therapy Copay