Background. Physical therapists (PTs) in the U.S. military practice direct access and can order limited prescription medications, imaging studies. Military PTs function as autonomous primary care managers (PCMs) for patients with musculoskeletal (MSK) disorders. Objective. The study compared cost of PT management of patients with MSK disorders to management by traditional PCMs; medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods. The researcher used a retrospective study of electronic medical records, using an exploratory, non-experimental, cross-sectional, and quantitative design method. Results. At an Air Force military medical clinic during an 18-month period from January 2016 through June 2017, 8,053 patients with MSK disorders were assessed. PT management of MSK patients resulted in a significantly lower rate of imaging studies, NSAIDS and cost of care when compared to MDs, DOs, PAs, or ARNPs. Patients with MSK disorders managed by PTs had no significant difference in return to work rate when compared to MDs, DOs, PAs, or ARNPs. Limitations. Data was collected at one Air Force medical clinic, with the majority of patients being active duty military. Conclusions. Findings suggest that PTs returned patients to work on par with care provided by traditional PCM’s. However, PTs used significantly fewer medications and imaging studies resulting in less overall cost of care. Longitudinal studies looking at recurrence rate of MSK conditions comparing non-PT PCMs to traditional PCMs manage would be of value when assessing cost over time. Keywords: Direct access physical therapy, primary care physical therapy.