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Defense Health Agency

"On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."

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 following site 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.)

CMS DMEPOS Fee Schedule.

For all other items of DMEPOS, TRICARE pays a maximum allowable charge. For further information, please contact your Regional Healthcare 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