| Service |
Coverage |
Authorization Requirements |
Co-Pay: Active duty dependents & retirees with Medicare Part B |
Co-Pay: Retirees without Medicare Part B |
| Pacemaker Monitoring |
Covered |
No |
No |
No |
| Pain Management Procedures and Treatments |
Covered |
Yes |
No |
Yes |
| Parenteral Nutrition and related supplies |
Covered (primary nutritional source) |
Yes |
No |
Yes |
| Patient Call Device |
Not covered |
N/A |
N/A |
N/A |
| Patient Lifts |
Covered |
Obtain from Apria |
No |
Yes |
| Penile Implant |
Limited |
Yes |
No |
Yes |
| Percussor |
Covered |
Obtain from Apria |
No |
Yes |
| Percutaneous Vertebroplasty |
Covered |
Yes |
No |
Yes |
| Peritoneal Dialysis |
Covered |
Yes - initial visit minimum |
No |
Yes |
| PET Scan |
Covered |
Yes |
No |
No |
| PFT (Pulmonary Function Test) |
Covered |
No |
No |
Yes |
| Pharmacy (prescription medications) |
Covered, TRICARE Uniform Formulary |
Yes - some medications may require pre-authorization per TRICARE Uniform Formulary |
Yes |
Yes |
| Photopheresis |
Covered |
Yes |
No |
Yes |
| Physical Therapy, home care |
Covered |
Yes |
No |
Yes |
| Physical Therapy, inpatient |
Covered |
Yes |
No |
No (included under admission) |
| Physical Therapy, outpatient |
Covered |
Contact Orthonet |
No |
Yes |
| Plastic Surgery |
Limited |
Yes |
No |
Yes |
| Pneumatic Compression Device and Sleeve |
Covered |
Yes |
No |
Yes |
| Podiatry Services |
Limited |
No |
No |
Yes |
| Polysomnography (sleep study) |
Covered |
No - routine diagnostic study; Yes - unattended home study |
No |
Yes |
| Positioning Devices |
Covered |
Obtain from Apria |
No |
Yes |
| Post-Mastectomy Bra |
Covered |
Yes - quantity limitations 2 initial and 2 replacements every 12 months |
No |
Yes |
| Postural Drainage Board |
Covered |
Yes - If $1,000 or greater |
No |
Yes |
| Power Wheeled Mobility Devices |
Limited |
Yes - Mt Holly Surgical Supply is the preferred vendor for NJ and PA |
No |
Yes |
| Pressure Stocking |
Covered |
Yes - Quantity limit - 2 pair every 12 months |
No |
Yes |
| Preventative Health Screenings |
Covered |
No |
No |
No |
| Private Duty Nurse |
Not covered |
N/A |
N/A |
N/A |
| Private Duty Nursing |
Not Covered |
N/A |
N/A |
N/A |
| Proctosigmoidoscopy |
Covered |
No |
No |
Yes |
| Prosthetic implants |
Covered |
Yes |
No |
Yes |
| Prosthetics |
Covered |
Yes - depends on item |
No |
Yes |
| Psychological Testing |
Covered |
Yes |
No |
Yes |
| Pulmonary Rehabilitation |
Covered |
Yes |
No |
Yes |
