How Do I Bill Same-Day, same CPT code TRICARE Sessions on One Claim?

When a client has two or more matching sessions on the same day, clearinghouses such as Office Ally and ClaimMD often reject the separate claims as duplicates before they reach TRICARE. Theralytics now combines those sessions into a single claim, with one service line per session, so the claim passes duplicate checks and still shows every session's details.

Before You Start

• The payer profile setting for Tricare must be enabled for this function to work

• No other setup is required. Non-TRICARE payers are not affected.

When Sessions Are Combined

Sessions combine into one claim only when all of the following match:

• Client

• Date of Service (DOS)

• Place of Service (POS)

• CPT code (for example, 97153 or 97155)

• Modifier(s)

• Rendering Provider NPI

If any one of these is different, Theralytics creates separate claims, just as it does today.

Billing Combined Sessions

1. Schedule and render each session as usual.

2. Go to Billing --> Ready To Bill.

3. Find the claim. Matching sessions appear under one Claim ID, with a separate service line for each session.

4. Review each line's units, start/stop times, and rendering provider.

5. Generate the CMS-1500 or EDI 837 as usual.

Picture 1: Combined TRICARE claim with one line per session

What the Claim Looks Like

Two sessions for the same client on 07/15/2026, both 97153 with the same rendering provider:

• Line 1: 09:00–11:00, 97153, 8 units

• Line 2: 14:00–16:00, 97153, 8 units

Both lines are billed under one Claim ID. On the CMS-1500, each session is its own line in Box 24, and Box 28 shows the total of all lines. The EDI 837 also sends each session as its own service line with its start/stop times.

Note: Units are never added together. Two 8-unit sessions stay as two lines of 8 units, not one line of 16.