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TRICARE Rates FAQs
How are the current Ambulatory Surgery (ASC) rates determined?
ASC rates are based on the type of service, whether the provider is an outpatient institution or a freestanding Ambulatory Surgery Center (ASC) and geographic location. Actual payment may vary. Find out more about the Ambulatory Surgery Rates System.
How does TRICARE determine the current Diagnostic Related Group (DRG) Weights and Rates?
A payment system for inpatient facilities sets payment levels for each DRG. The rates are based on the average cost of treatment for all TRICARE patients in a specific DRG. Note: Although there are basic similarities between Medicare and TRICARE DRGs, there are significant differences in the final calculations. Find out more about the TRICARE DRG-Based Payment System.
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