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No Government Pay Procedure Code List

This list is used as an editing tool only.

  • Please consult the authoritative guidance found in the TRICARE Policy Manual or TRICARE Reimbursement Manual to obtain specific information on TRICARE policy, benefits, and coverage.
  • You may also contact the Managed Care Support Contractor in your region to obtain further information.

In addition, there may be other policy or special program provisions (such as Demonstration programs listed in the TRICARE Operations Manual, the Extended Care Health Option (ECHO), etc. that affect listed codes, coverage or reimbursement. View the TRICARE Manuals

Last Updated: September 02, 2022

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