Skip to main content

Military Health System

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

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

TRICARE Fee Schedule Rates for DMEPOS and PEN Items Not Listed on the Medicare Fee Schedule

For more information refer to the TRICARE Reimbursement Manual, Chapter 1, Section 11 and the Notice (85 FR 85613) published at:

https://www.federalregister.gov/documents/2020/12/29/2020-28762/tricare-proposed-rates-for-reimbursing-durable-medical-equipment-prosthetics-orthotics-and-supplies

Download

Breastfeeding Supplies Reimbursement

Download

Cast and Splint Reimbursement

Download
Last Updated: March 16, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery