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TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
Operational Requirements
Chapter 3
Section 7
No Government Pay Procedure Codes
Issue Date:  
Authority:  32 CFR 199.2 and 32 CFR 199.6(f)
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-21, May 30, 2018
1.0  General
For the list of the No Government Pay Procedure Codes that are excluded from TRICARE coverage and are not payable under TRICARE, refer to the No Government Pay List (NGPL) on Defense Health Agency's (DHA's) website at The NGPL shall be used in conjunction with the TRICARE Policy Manual (TPM), which in addition to any definitions, requirements, conditions, or limitations enumerated and described in other sections of the Manuals, provides clarification and additional services, equipment and supplies that are specifically excluded from payment under TRICARE.
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