NEW! Autism Care Demonstration (ACD): Check out the latest update to the ACD program.
NEW! Delayed Payment Cycle: The last non-underwritten and underwritten cycles for fiscal year 2015 will occur on September 24. The next cycle for both will occur on October 1. During this time frame, payments will be delayed. We apologize for the inconvenience and thank you for your patience.
Breast Pump Policy Update: TRICARE policy has been updated to include the coverage of breast pumps and supplies and breastfeeding counseling, effective July 1, 2015.
Air Ambulance Services: Air ambulance services on or after October 1, 2014, shall be paid the greater of the Medicare AFS or the TRICARE provisional air ambulance CMAC. For the initial transition period of October 1, 2014 through December 31, 2015, the TRICARE provisional air ambulance CMAC shall be calculated as 85% of the base year rate established under TRICARE Reimbursement Manual paragraph 22.214.171.124.
Consultations and Follow-Up Reports: Consult reporting is an essential step to facilitate appropriate continuity of care for all TRICARE beneficiaries. Learn more about submitting consult reports.
Outpatient Prospective Payment System (OPPS): Centers for Medicare & Medicaid Services (CMS) implements quarterly updates to OPPS. Information related to the October 2015 update is available directly from CMS. Please note: Medicare specific coding requirements must be followed (with the exception of DHA developed APCs) in order to receive TRICARE reimbursement under the OPPS.
Performance: check out the West Region Report Card!
ALERT! EDI Submitters: Prevent your TRICARE claims from rejecting with the Invalid Member ID (H65) edit.
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