TRICARE Physical Therapy Coverage & Costs (2026)
*TRICARE.com is an independent reference site and is not the official TRICARE program or affiliated with the Department of Defense. For official policy and the most current enrollment data, visit TRICARE.mil.*
## Quick answer TRICARE covers physical therapy (PT) when it is medically necessary and prescribed by a licensed physician or authorized provider to treat a specific illness or injury. For most plans, you do not need a referral for the initial evaluation, but a referral or pre-authorization is typically required for continuing treatment sessions.
Details
TRICARE physical therapy coverage is designed to help patients restore function, improve mobility, and relieve pain following surgery, injury, or diagnosis of a chronic condition. Coverage is generally limited to services provided by a licensed physical therapist or an authorized physical therapist assistant under supervision.
### Referrals and Authorizations The requirement for a referral depends on your plan and beneficiary status: * **TRICARE Prime:** Active Duty Service Members (ADSMs) always need a referral. Active Duty Family Members (ADFMs) usually need a referral from their Primary Care Manager (PCM) to see a specialist, including a physical therapist. * **TRICARE Select:** Referrals are generally not required for network providers, but the services must still meet medical necessity guidelines. * **Point of Service (POS):** If you use the POS option under Prime to see a physical therapist without a referral, you will face significantly higher out-of-pocket costs and a deductible.
### Cost-Sharing and Copays (2026 Rates) Costs vary based on your "Group" status (Group A joined before Jan 1, 2018; Group B joined on or after that date) and your plan:
* **Active Duty Service Members:** $0 out-of-pocket for all covered PT. * **TRICARE Prime (Retirees/Families):** Costs for specialty care visits (including PT) generally range from $25 to $40 per visit, depending on Group status. * **TRICARE Select (Retirees/Families):** Network copays typically range from $35 to $60 per visit after the annual deductible is met. * **Non-Network:** You may pay 20–25% of the TRICARE allowable charge, plus any "balance billing" amounts from the provider.
### Specific Exclusions TRICARE does not cover physical therapy for: * **General fitness:** Exercises to improve overall health or athletic performance. * **Diathermy/Ultrasound:** When used solely for non-medical relaxation or heat. * **Maintenance therapy:** Services that do not result in documented physiological improvement (with some exceptions for specific chronic conditions like Multiple Sclerosis). * **Alternative therapies:** Procedures such as dry needling remain a subject of evolving policy; check with your regional contractor (Humana Military in the East or TriWest in the West) for current demonstration project status in your area.
### Limits on Sessions While TRICARE does not have a hard "cap" on the number of sessions allowed per year, all sessions must be medically necessary. After an initial block of visits (usually 12), your physical therapist must submit a progress report and a request for additional authorization to your regional contractor.
## Who this affects * **Active Duty Service Members:** Full coverage, referral required. * **Active Duty Family Members:** Covered under Prime (referral needed) and Select (no referral usually needed). * **Retirees and their Families:** Covered; copays apply based on plan and Group status. * **National Guard and Reserve:** Covered under TRICARE Reserve Select (TRS) or TRICARE Retired Reserve (TRR). * **Survivors and Medically Retired:** Maintain coverage similar to active duty or retiree categories.
## Sources * **TRICARE.mil:** [Physical Therapy Page](https://www.tricare.mil/CoveredServices/IsItCovered/PhysicalTherapy) * **Humana Military (East Region):** [Provider Services and Authorizations](https://www.humanamilitary.com) * **TriWest Healthcare Alliance (West Region):** [Member Benefits and Referrals](https://www.triwest.com) * **TRICARE 2026 Costs:** [TRICARE Cost Search Tool](https://www.tricare.mil/costs)