TRICARE uses the reimbursement rates established by the Centers for Medicare and Medicaid Services (CMS) for certain items and services of Durable Equipment (DE), Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Parenteral and Enteral Nutrition (PEN).

• CMS updates these rates on a quarterly basis in January, April, July, and October when necessary.
• Inclusion or exclusion of a reimbursement rate does not imply TRICARE coverage.

Please visit the CMS DMEPOS Fee Schedule to access DMEPOS and PEN reimbursement rates for certain items and services that begin with a HCPCS code of A, B, E, K, L, Q, 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