TRICARE Cautions Off-Label Use of FDA-Approved Medications for Tocolysis

Obstetric, gynecologic and home health care providers should be aware TRICARE does not cover off-label use of FDA-approved drugs to induce or maintain tocolysis. Tocolysis is the delaying or inhibition of labor during the birth process. TRICARE only covers care proven to be safe and effective for controlling contractions during pre-term labor.

There are providers who use Terbutaline to slow uterine contractions during preterm labor. However, this is an unlabeled use of Terbutaline that is not covered by TRICARE. TRICARE and many other commercial health care plans consider Terbutaline use for controlling preterm contractions unproven, and therefore it is not covered.

If you treat patients who experience preterm uterine contractions, use medications specifically designed or labeled for that purpose so you can be appropriately reimbursed by TRICARE.

If you are uncertain about TRICARE coverage for a particular medication, call TriWest at 1-888-TRIWEST (1-888-874-9378).