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Bundled Codes

Under TRICARE's reimbursement policy:

  • TRICARE follows Medicare’s bundling provisions for professional services.
  • All services integral to accomplishing a procedure are considered bundled into that procedure and, therefore, are considered a component part of the comprehensive code.
  • Many of these generic activities are common to virtually all procedures and, on other occasions, some are integral to only a certain group of procedures, but are still essential to accomplish these particular procedures.
  • It is inappropriate to separately bill these services based on standard medical and surgical principles.

The following list of CPT/HCPCS Codes specifies those services that are not paid separately.

Applicable FARS/DFARS Restrictions Apply to Government Use

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

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