Noncovered conditions and treatments

All services and supplies related to a noncovered condition or treatment are excluded. Before delivering care, network providers must notify TRICARE patients if services are not covered. The beneficiary must agree in advance and in writing to receive and accept financial responsibility for noncovered services by signing the TRICARE noncovered services waiver form. To obtain specific information on TRICARE policy, benefits and coverage, please consult the TRICARE Policy Manual or TRICARE Reimbursement Manual or the code look up feature on provider self-service.

Those include:

  • Aversion therapy (e.g. electric shock and use of chemicals for alcoholism, except disulfiram, which is covered for the treatment of alcoholism)
  • Behavioral healthcare services and supplies related solely to obesity and/or weight reduction
  • Biofeedback for psychosomatic conditions
  • Counseling services that are not considered medically necessary in the treatment of a diagnosed medical condition. (i.e. nutritional counseling, stress management, marital therapy, or lifestyle modifications)
  • Custodial care
  • Educational programs
  • Experimental procedures
  • Inpatient stays primarily for rest or rest cures
  • Megavitamin or orthomolecular therapy
  • Psychoanalysis or psychotherapy provided to a beneficiary or any member of the immediate family that is credited towards earning a degree or furtherance of the education or training of a beneficiary or sponsor, regardless of diagnosis or symptoms that may be present
  • Sedative action electrostimulation therapy
  • Services and supplies above the appropriate level required to provide necessary care
  • Services and supplies related to an inpatient admission that could have been and are performed routinely on an outpatient basis
  • Services and supplies that are (or are eligible to be) payable under another medical insurance or program (including private or governmental, such as coverage through employment or Medicare)
  • Sex therapy, sexual advice, sexual counseling, sex behavior modification or psychotherapy and any supplies provided in connection with therapy for sexual dysfunctions, inadequacies or paraphilic disorders
  • Stellate ganglion block for the treatment of PTSD
  • Therapy for developmental disorders (including dyslexia, language, mathematics disorders and articulation disorders)
  • Therapeutic absences from inpatient facility, except when such absences are specifically included in a treatment plan approved by TRICARE

View a complete list of behavioral healthcare services that are excluded under TRICARE or are covered with significant limitations

Behavioral healthcare