Robotic Surgical Assistance Not Covered by TRICARE

Providers should be aware that the TRICARE Policy Manual currently excludes payment for robotically performed procedures. According to the TRICARE Policy Manual, Chapter 1, Section 2.2., HCPCS code S2900 is considered unproven and is listed on the Government No Pay Code list found at http://www.tricare.mil/nogovernmentpay/.

TriWest will pay the primary code for the surgery, but deny the code for robotic surgical assistance. If the robotic assistance is not billed separately but is noted in the operative report, the claim will be paid at the regular contracted surgery rate without any additional payment for the robotic assistance

For further information, refer to www.tricare.mil or call 1-888-TRIWEST (888-874-9378).