TRICARE uses the reimbursement rates established by the Centers for Medicare and Medicaid Services (CMS) for certain items of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies.
- CMS updates these rates twice a year in January and July.
- Inclusion or exclusion of a reimbursement rate does not imply TRICARE coverage.
Please visit the CMS DMEPOS Fee Schedule to access DMEPOS reimbursement rates for those items that begin with a HCPCS code of A, E, K, L, or V. (Link will open in a new browser window.)
For all other items of DMEPOS, TRICARE pays a maximum allowable charge. For further information, please contact your regional contractor or see the following TRICARE Reimbursement Manual references:
- Chapter 1, Section 11
- Chapter 3, Section 1
- Chapter 5, Section 1
Cast and Splint Reimbursement
Applicable FARS/DFARS Restrictions Apply to Government Use