Tricare has removed Current Procedural Terminology® vision screening codes 99174 and 99177 from the No Government Pay Procedure Code List for children aged 1 to 6 years. This policy was implemented May 18, 2020. The American Academy of Pediatrics advocated for this change.

Tricare should start retroactively reprocessing claims back to the effective date of December 2, 2019. If you have submitted claims tied to these codes for services provided on or after December 2, 2019, it is advisable to resubmit them or request a claim reprocessing/payment reconsideration. Tricare pays separately for instrument-based vision screening for children aged 1 to 6 years when this service is provided by a physician other than an ophthalmologist or optometrist as part of a well-child program.

For more information, please visit https://manuals.health.mil/pages/DisplayManualHtmlFile/TP15/63/AsOf/TP15/c7s2_5.html#FM66760.

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