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.
Download
You are leaving Health.mil
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.
You are leaving Health.mil
View the external links disclaimer.
Last Updated: April 26, 2023