Skip to main content

Military Health System

Utility Navigation Links

TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 7
Section 4.2
Issue Date:  January 23, 1984
Authority:  32 CFR 199.4
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-110, May 31, 2023
90918 - 90999
2.1  End Stage Renal Disease (ESRD) services, hemodialysis, peritoneal dialysis, treatment for Acute Kidney Injury (AKI), and other dialysis services and supplies are covered. Covered services include:
•  Inpatient dialysis treatments when medically necessary and appropriate.
•  Outpatient dialysis treatments and outpatient individual professional provider services rendered by TRICARE-authorized providers.
•  Home dialysis, including home dialysis training and home dialysis equipment and supplies. Note: Dialysis training must be medically necessary and documented in the medical record, for example, if additional training is required because of a change in equipment.
•  Other drugs, services, and supplies that are medically necessary and appropriate, and required as part of the dialysis care (e.g., laboratory services).
2.2  The contractor shall ensure that the dialysis course of treatment is medically necessary and appropriate, and that the attending or prescribing individual professional provider has documented the frequency of dialysis services in the patient’s medical record and plan of care.
The services of dialysis aids, attendants, or assistants.
- END -
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery