What Happened
TRICARE recently made a quiet but damaging change to its reimbursement policy. As of January 2025, psychiatric mental health nurse practitioners (PMHNPs) and physician assistants (PAs) are no longer reimbursed for providing psychotherapy add-on services (CPT codes 90833, 90836, and 90838) during routine mental health visits.

This change means that if a provider spends 45 minutes supporting a veteran with therapy and medication management — as is standard, evidence-based practice — TRICARE now pays only for the medication portion. The therapy is no longer recognized or reimbursed.

Why It Matters
This decision is already having serious consequences:

• Providers are reconsidering whether they can remain in-network with TRICARE.
• Appointments are being shortened, and therapy is being dropped.
• Veterans and military families are losing access to trusted providers.
• Entire communities — especially rural or underserved areas — are at risk of being left without qualified mental health care.
• This is not just a billing issue. It is a values issue. And potentially a legal one.

By treating mental health therapy differently than comparable medical services, this policy may violate the Mental Health Parity and Addiction Equity Act, which requires health insurers to treat mental health and substance use disorder benefits equal to medical/surgical care.

What We’re Asking For
We call on the Defense Health Agency and TRICARE to:

1. Immediately reinstate reimbursement for psychotherapy CPT codes 90833, 90836, and 90838 when used by psychiatric nurse practitioners and physician assistants.
2. Re-evaluate TRICARE’s reimbursement model for mental health services to ensure sustainability, quality, and compliance with the Mental Health Parity Act.
3. Engage directly with providers, patients, and veterans to understand the real-world impact of these changes.

This is a preventable crisis. Let’s fix it before more providers walk away — and more veterans are left behind.

Add your name to demand TRICARE and DHA reverse this harmful policy and protect access to comprehensive, integrated mental health care for veterans.