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Limits on Number of Services without Override Code

This list contains Maximum Numbers of Services Per Day for Procedure Codes. A TRICARE Encounter Data (TED) Record will be rejected if it contains a code on this list and a Number of Services Per Day which exceeds the maximum for that code. If the TRICARE contractor has determined that a Number of Services Per Day which exceeds the maximum is medically necessary, they must indicate that by using an Override Code of NS.

The existence of a Procedure Code on this list does not necessarily mean that it is payable. TRICARE's No Government Pay List and all other TRICARE Policy constraints on payment continue to apply.

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