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TRICARE Operations Manual 6010.62-M, April 2021
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TRICARE Reimbursement Manual 6010.64-M, April 2021
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TRICARE Operations Manual 6010.59-M, April 2015
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TRICARE Systems Manual 7950.3-M, April 2015
Other Manuals
32 CFR 199 (DHA Version), December 2016
DoD Women, Infants, and Children (WIC) Overseas Program Policy Manual, July 2017
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TRICARE Reimbursement Manual 6010.58-M, February 2008
Manual Change History
TRICARE Reimbursement Manual 6010.58-M, February 2008
Master TOC
Change 159 (May 23, 2018)
Baseline (February 1, 2008)
Foreword
Baseline (February 1, 2008)
Chap 1 -- General
Change 194 (April 8, 2021)
Change 191 (February 2, 2021)
Change 179 (September 26, 2019)
Change 173 (March 18, 2019)
Change 172 (March 11, 2019)
Change 152 (November 29, 2017)
Change 151 (November 8, 2017)
Change 144 (June 13, 2017)
Change 118 (November 20, 2015)
Change 96 (May 19, 2014)
Change 88 (September 14, 2013)
Change 75 (November 26, 2012)
Change 71 (August 24, 2012)
Change 65 (April 27, 2012)
Change 46 (April 4, 2011)
Change 28 (July 8, 2010)
Change 19 (October 29, 2009)
Change 12 (September 18, 2009)
Change 8 (June 3, 2009)
Change 7 (May 28, 2009)
Change 4 (November 7, 2008)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 1 -- Network Provider Reimbursement
Baseline (February 1, 2008)
Sect 2 -- Accommodation Of Discounts Under Provider Reimbursement Methods
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 3 -- Claims Auditing Software
Baseline (February 1, 2008)
Sect 4 -- Reimbursement In Teaching Setting
Baseline (February 1, 2008)
Sect 5 -- National Health Service Corps Physicians Of The Public Health Service
Baseline (February 1, 2008)
Sect 6 -- Reimbursement Of Physician Assistants (PAs), Nurse Practitioners (NPs), And Certified Psychiatric Nurse Specialists (CPNSs)
Change 73 (September 24, 2012)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 7 -- Reimbursement Of Covered Services Provided By Individual Health Care Professionals And Other Non-Institutional Health Care Providers
Change 144 (June 13, 2017)
Change 94 (March 31, 2014)
Baseline (February 1, 2008)
Sect 8 -- Economic Interest In Connection With Mental Health Admissions
Change 144 (June 13, 2017)
Baseline (February 1, 2008)
Sect 9 -- Anesthesia
Baseline (February 1, 2008)
Sect 10 -- Postoperative Pain Management - Epidural Analgesia
Baseline (February 1, 2008)
Sect 11 -- Claims For Durable Equipment (DE) And Durable Medical Equipment, Prosthetics, Orthotics, And Supplies (DMEPOS)
Change 196 (June 29, 2021)
Change 172 (March 11, 2019)
Change 151 (November 8, 2017)
Change 118 (November 20, 2015)
Change 117 (September 8, 2015)
Change 91 (December 6, 2013)
Change 48 (April 8, 2011)
Change 36 (September 14, 2010)
Change 34 (August 10, 2010)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 12 -- Oxygen And Related Supplies
Baseline (February 1, 2008)
Sect 13 -- Laboratory Services
Change 12 (September 18, 2009)
Change 6 (May 20, 2009)
Baseline (February 1, 2008)
Sect 14 -- Ambulance Services
Change 178 (September 19, 2019)
Change 165 (October 18, 2018)
Change 115 (August 24, 2015)
Change 98 (June 19, 2014)
Change 88 (September 14, 2013)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 15 -- Legend Drugs And Insulin
Change 181 (December 12, 2019)
Change 146 (August 1, 2017)
Change 106 (November 4, 2014)
Change 70 (July 27, 2012)
Change 56 (September 26, 2011)
Baseline (February 1, 2008)
Sect 16 -- Surgery
Change 134 (November 8, 2016)
Change 127 (February 18, 2016)
Change 122 (January 12, 2016)
Change 117 (September 8, 2015)
Change 96 (May 19, 2014)
Change 83 (July 16, 2013)
Change 26 (March 12, 2010)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 17 -- Assistant Surgeons
Change 185 (April 16, 2020)
Change 96 (May 19, 2014)
Baseline (February 1, 2008)
Sect 18 -- Professional Services: Obstetrical Care
Baseline (February 1, 2008)
Sect 19 -- Charges For Provider Administrative Expenses
Baseline (February 1, 2008)
Sect 20 -- State Agency Billing
Change 103 (September 22, 2014)
Change 85 (August 22, 2013)
Change 71 (August 24, 2012)
Change 62 (March 16, 2012)
Change 41 (January 31, 2011)
Baseline (February 1, 2008)
Sect 21 -- Hospital Reimbursement - Billed Charges Set Rates
Change 87 (September 13, 2013)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 22 -- Hospital Reimbursement - Other Than Billed Charges
Change 87 (September 13, 2013)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 23 -- Hospital Reimbursement - Payment When Only Skilled Nursing Facility (SNF) Level Of Care Is Required
Baseline (February 1, 2008)
Sect 24 -- Hospital Reimbursement - Outpatient Services
Change 147 (August 22, 2017)
Change 96 (May 19, 2014)
Change 64 (April 25, 2012)
Change 26 (March 12, 2010)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 25 -- Preferred Provider Organization (PPO) Reimbursement
Baseline (February 1, 2008)
Sect 26 -- Supplemental Insurance
Baseline (February 1, 2008)
Sect 27 -- Legal Obligation To Pay
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 28 -- Reduction Of Payment For Noncompliance With Utilization Review Requirements
Change 178 (September 19, 2019)
Change 148 (October 19, 2017)
Change 144 (June 13, 2017)
Change 52 (September 8, 2011)
Change 50 (June 27, 2011)
Baseline (February 1, 2008)
Sect 29 -- Reimbursement Of Emergency Inpatient Admissions To Unauthorized Facilities
Baseline (February 1, 2008)
Sect 30 -- Reimbursement Of Certain Prime Travel Expenses For Specialty Care Over 100 Miles Away
Change 95 (April 7, 2014)
Change 65 (April 27, 2012)
Change 28 (July 8, 2010)
Baseline (February 1, 2008)
Sect 31 -- Newborn Charges
Baseline (February 1, 2008)
Sect 32 -- Hospital-Based Birthing Room
Baseline (February 1, 2008)
Sect 33 -- Bonus Payments In Health Professional Shortage Areas (HPSAs)
Change 148 (October 19, 2017)
Change 118 (November 20, 2015)
Change 109 (January 8, 2015)
Change 96 (May 19, 2014)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 34 -- Hospital Inpatient Reimbursement In Locations Outside The 50 United States And The District Of Columbia
Change 193 (April 1, 2021)
Change 182 (March 12, 2020)
Change 168 (January 14, 2019)
Change 155 (February 5, 2018)
Change 148 (October 19, 2017)
Change 137 (December 29, 2016)
Change 136 (December 22, 2016)
Change 103 (September 22, 2014)
Change 85 (August 22, 2013)
Change 75 (November 26, 2012)
Change 71 (August 24, 2012)
Change 8 (June 3, 2009)
Change 4 (November 7, 2008)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 35 -- Professional Provider Reimbursement In Specified Locations Outside The 50 United States And The District Of Columbia
Change 148 (October 19, 2017)
Change 130 (June 17, 2016)
Change 92 (December 12, 2013)
Change 76 (December 13, 2012)
Change 75 (November 26, 2012)
Change 4 (November 7, 2008)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 36 -- Forensic Examinations Following Sexual Assault or Domestic Violence
Change 19 (October 29, 2009)
Baseline (February 1, 2008)
Sect 37 -- Medical Errors
Change 85 (August 22, 2013)
Change 71 (August 24, 2012)
Change 46 (April 4, 2011)
Baseline (February 1, 2008)
Sect 38 -- Reimbursement of State Vaccine Programs (SVPs)
Change 174 (June 17, 2019)
Change 163 (August 14, 2018)
Change 152 (November 29, 2017)
Baseline (February 1, 2008)
Sect 39 -- CHAMPUS Maximum Allowable Charge (CMAC) For Banked Donor Milk (BDM)
Change 182 (March 12, 2020)
Change 173 (March 18, 2019)
Baseline (February 1, 2008)
Sect 40 -- Organ Acquisition Costs
Change 188 (December 17, 2020)
Change 179 (September 26, 2019)
Baseline (February 1, 2008)
Sect 41 -- Hospital Reimbursement - Hospital Value-Based Purchasing (HVBP)
Change 191 (February 2, 2021)
Baseline (February 1, 2008)
Sect 42 -- Temporary Reimbursement Changes in Response to Coronavirus Disease 2019 (COVID-19) Pandemic
Change 200 (August 2, 2022)
Change 194 (April 8, 2021)
Baseline (February 1, 2008)
Addendum A -- Sample State Agency Billing Agreement
Change 103 (September 22, 2014)
Change 94 (March 31, 2014)
Change 85 (August 22, 2013)
Change 71 (August 24, 2012)
Baseline (February 1, 2008)
Addendum B -- Figures
Baseline (February 1, 2008)
Addendum C -- Minimum Requirements For Reimbursement Of Per Capita Based (Or Alternative) State Vaccine Programs (SVPs)
Change 152 (November 29, 2017)
Baseline (February 1, 2008)
Addendum D -- Maximum Allowable Charge For Breastfeeding Supplies
Change 196 (June 29, 2021)
Change 172 (March 11, 2019)
Baseline (February 1, 2008)
Chap 2 -- Beneficiary Liability
Change 189 (December 23, 2020)
Change 180 (November 26, 2019)
Change 160 (June 14, 2018)
Change 158 (May 2, 2018)
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 1 -- Cost-Shares And Deductibles For TRICARE Services Received Prior To January 1, 2018 And For TRICARE Services Received On Or After January 1, 2018 By TRICARE for Life (TFL) Beneficiaries
Change 197 (August 4, 2021)
Change 195 (April 19, 2021)
Change 189 (December 23, 2020)
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Change 167 (January 3, 2019)
Change 166 (November 5, 2018)
Change 164 (September 13, 2018)
Change 160 (June 14, 2018)
Change 157 (March 6, 2018)
Change 150 (October 26, 2017)
Change 148 (October 19, 2017)
Change 144 (June 13, 2017)
Change 136 (December 22, 2016)
Change 133 (November 2, 2016)
Change 132 (October 13, 2016)
Change 121 (December 21, 2015)
Change 119 (December 4, 2015)
Change 117 (September 8, 2015)
Change 116 (August 31, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 71 (August 24, 2012)
Change 58 (November 10, 2011)
Change 44 (March 2, 2011)
Change 37 (October 20, 2010)
Change 18 (October 23, 2009)
Change 16 (October 16, 2009)
Change 15 (October 9, 2009)
Change 7 (May 28, 2009)
Change 5 (May 15, 2009)
Change 4 (November 7, 2008)
Change 2 (May 15, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 2 -- Cost-Shares And Deductibles For TRICARE Services Received On Or After January 1, 2018
Change 192 (March 25, 2021)
Change 189 (December 23, 2020)
Change 186 (June 8, 2020)
Change 167 (January 3, 2019)
Change 166 (November 5, 2018)
Change 164 (September 13, 2018)
Change 160 (June 14, 2018)
Change 153 (January 25, 2018)
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 3 -- Catastrophic Loss Protection For TRICARE Services Received Prior To January 1, 2018; And For TRICARE Services Received On Or After January 1, 2018, By TRICARE For Life (TFL) Beneficiaries
Change 197 (August 4, 2021)
Change 175 (June 27, 2019)
Change 164 (September 13, 2018)
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 4 -- Catastrophic Loss Protection For TRICARE Services Received On Or After January 1, 2018
Change 177 (August 29, 2019)
Change 164 (September 13, 2018)
Change 160 (June 14, 2018)
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 5 -- Point Of Service (POS) Option
Change 164 (September 13, 2018)
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 6 -- Waivers of Cost-Shares and Deductibles
Change 148 (October 19, 2017)
Baseline (February 1, 2008)
Sect 7 -- Temporary Waivers of Copayments and Cost-Shares (Including Deductibles) in Response to Coronavirus 2019 (COVID-19) Pandemic
Change 200 (August 2, 2022)
Change 189 (December 23, 2020)
Baseline (February 1, 2008)
Addendum A -- Benefits And Beneficiary Payments Under The TRICARE Program For Services Received Prior To January 1, 2018; And For TRICARE Services Received On Or After January 1, 2018 By TRICARE For Life (TFL) Beneficiaries
Change 160 (June 14, 2018)
Change 153 (January 25, 2018)
Change 148 (October 19, 2017)
Change 144 (June 13, 2017)
Change 143 (March 28, 2017)
Change 132 (October 13, 2016)
Change 125 (February 8, 2016)
Change 115 (August 24, 2015)
Change 113 (August 12, 2015)
Change 110 (January 12, 2015)
Change 100 (June 30, 2014)
Change 84 (July 31, 2013)
Change 72 (September 21, 2012)
Change 67 (May 7, 2012)
Change 57 (September 28, 2011)
Change 18 (October 23, 2009)
Change 7 (May 28, 2009)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Addendum B -- Pharmacy Benefits Program - Cost-Shares
Change 180 (November 26, 2019)
Change 158 (May 2, 2018)
Change 144 (June 13, 2017)
Change 124 (January 27, 2016)
Change 111 (March 12, 2015)
Change 82 (July 11, 2013)
Change 78 (January 31, 2013)
Change 54 (September 21, 2011)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Chap 3 -- Operational Requirements
Change 174 (June 17, 2019)
Change 70 (July 27, 2012)
Change 21 (November 10, 2009)
Baseline (February 1, 2008)
Sect 1 -- Reimbursement Of Individual Health Care Professionals And Other Non-Institutional Health Care Providers
Change 123 (January 19, 2016)
Change 96 (May 19, 2014)
Change 94 (March 31, 2014)
Change 55 (September 23, 2011)
Change 7 (May 28, 2009)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 2 -- Hospital And Other Institutional Reimbursement
Change 87 (September 13, 2013)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Change 4 (November 7, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 3 -- Discounts
Change 148 (October 19, 2017)
Change 136 (December 22, 2016)
Change 87 (September 13, 2013)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 4 -- Payment Reduction
Change 144 (June 13, 2017)
Baseline (February 1, 2008)
Sect 5 -- Reimbursement Administration
Baseline (February 1, 2008)
Sect 6 -- Processing And Payment Of Home Infusion Claims Before January 30, 2012
Change 106 (November 4, 2014)
Change 70 (July 27, 2012)
Change 21 (November 10, 2009)
Baseline (February 1, 2008)
Sect 7 -- Processing And Payment Of Home Infusion Claims On Or After January 30, 2012
Change 146 (August 1, 2017)
Change 106 (November 4, 2014)
Change 70 (July 27, 2012)
Baseline (February 1, 2008)
Sect 8 -- No Government Pay Procedure Codes
Change 174 (June 17, 2019)
Baseline (February 1, 2008)
Chap 4 -- Double Coverage
Baseline (February 1, 2008)
Sect 1 -- Double Coverage
Change 178 (September 19, 2019)
Change 87 (September 13, 2013)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 2 -- Double Coverage Review And Processing Of Claims
Change 164 (September 13, 2018)
Change 125 (February 8, 2016)
Change 4 (November 7, 2008)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 3 -- Coordination Of Benefits (COB)
Change 148 (October 19, 2017)
Change 144 (June 13, 2017)
Change 62 (March 16, 2012)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 4 -- Specific Double Coverage Actions
Change 178 (September 19, 2019)
Change 172 (March 11, 2019)
Change 164 (September 13, 2018)
Change 148 (October 19, 2017)
Change 137 (December 29, 2016)
Change 134 (November 8, 2016)
Change 93 (December 20, 2013)
Change 86 (September 11, 2013)
Change 73 (September 24, 2012)
Change 70 (July 27, 2012)
Change 62 (March 16, 2012)
Change 53 (September 13, 2011)
Change 45 (March 11, 2011)
Baseline (February 1, 2008)
Chap 5 -- Allowable Charges
Change 123 (January 19, 2016)
Baseline (February 1, 2008)
Sect 1 -- Providers
Change 88 (September 14, 2013)
Change 55 (September 23, 2011)
Baseline (February 1, 2008)
Sect 2 -- Locality-Based Reimbursement Rate Waiver
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 3 -- CHAMPUS Maximum Allowable Charges (CMAC)
Change 146 (August 1, 2017)
Change 123 (January 19, 2016)
Change 117 (September 8, 2015)
Change 90 (November 21, 2013)
Change 88 (September 14, 2013)
Change 59 (December 7, 2011)
Change 55 (September 23, 2011)
Change 26 (March 12, 2010)
Change 7 (May 28, 2009)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Sect 4 -- Payment For Professional/Technical Components Of Diagnostic Services
Change 149 (October 23, 2017)
Change 140 (March 9, 2017)
Change 123 (January 19, 2016)
Baseline (February 1, 2008)
Chap 6 -- Diagnostic Related Groups (DRGs)
Change 190 (January 7, 2021)
Change 181 (December 12, 2019)
Change 136 (December 22, 2016)
Change 119 (December 4, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 44 (March 2, 2011)
Change 16 (October 16, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 1 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (General)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 2 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (General Description Of System)
Change 117 (September 8, 2015)
Change 103 (September 22, 2014)
Change 89 (September 19, 2013)
Change 85 (August 22, 2013)
Change 71 (August 24, 2012)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 3 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Basis Of Payment)
Change 178 (September 19, 2019)
Change 174 (June 17, 2019)
Change 136 (December 22, 2016)
Change 117 (September 8, 2015)
Change 115 (August 24, 2015)
Change 102 (August 22, 2014)
Change 97 (June 5, 2014)
Change 44 (March 2, 2011)
Change 30 (July 16, 2010)
Change 16 (October 16, 2009)
Change 5 (May 15, 2009)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 4 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Applicability Of The DRG System)
Change 170 (February 7, 2019)
Change 147 (August 22, 2017)
Change 129 (June 14, 2016)
Change 103 (September 22, 2014)
Change 87 (September 13, 2013)
Change 85 (August 22, 2013)
Change 79 (April 4, 2013)
Change 71 (August 24, 2012)
Change 44 (March 2, 2011)
Change 27 (March 18, 2010)
Change 12 (September 18, 2009)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 5 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Determination Of Payment Amounts)
Baseline (February 1, 2008)
Sect 6 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (DRG Weighting Factors)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 7 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Adjusted Standardized Amounts (ASAs))
Change 195 (April 19, 2021)
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Change 157 (March 6, 2018)
Change 136 (December 22, 2016)
Change 119 (December 4, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 44 (March 2, 2011)
Change 16 (October 16, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 8 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Adjustments To Payment Amounts)
Change 195 (April 19, 2021)
Change 184 (April 7, 2020)
Change 182 (March 12, 2020)
Change 181 (December 12, 2019)
Change 178 (September 19, 2019)
Change 174 (June 17, 2019)
Change 170 (February 7, 2019)
Change 161 (July 2, 2018)
Change 157 (March 6, 2018)
Change 147 (August 22, 2017)
Change 136 (December 22, 2016)
Change 128 (April 6, 2016)
Change 119 (December 4, 2015)
Change 117 (September 8, 2015)
Change 108 (December 18, 2014)
Change 103 (September 22, 2014)
Change 92 (December 12, 2013)
Change 87 (September 13, 2013)
Change 85 (August 22, 2013)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Change 74 (October 16, 2012)
Change 71 (August 24, 2012)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Change 44 (March 2, 2011)
Change 35 (September 10, 2010)
Change 29 (July 13, 2010)
Change 16 (October 16, 2009)
Change 13 (September 28, 2009)
Change 10 (August 6, 2009)
Change 5 (May 15, 2009)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 9 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Information Provided By Defense Health Agency (DHA)
Change 181 (December 12, 2019)
Change 87 (September 13, 2013)
Baseline (February 1, 2008)
Sect 10 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (Charges To Beneficiaries)
Change 144 (June 13, 2017)
Baseline (February 1, 2008)
Sect 11 -- Hospital Reimbursement - TRICARE DRG-Based Payment System (New Technology Add-On Payments (NTAPs))
Change 193 (April 1, 2021)
Change 190 (January 7, 2021)
Baseline (February 1, 2008)
Addendum A -- Health Benefit Program Agreement
Baseline (February 1, 2008)
Addendum B -- TRICARE Adjusted Standardized Amounts (ASAs) - FY 2015
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Addendum B -- TRICARE Adjusted Standardized Amounts (ASAs) - FY 2016 And Beyond
Change 136 (December 22, 2016)
Baseline (February 1, 2008)
Addendum C -- Diagnosis Related Groups (DRGs), DRG Relative Weights, Arithmetic And Geometric Mean Lengths-Of-Stay (LOS), And Short-Stay Outlier Thresholds - FY 2015
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Addendum C -- Diagnosis Related Groups (DRGs), DRG Relative Weights, Arithmetic And Geometric Mean Lengths-Of-Stay (LOS), And Short-Stay Outlier Thresholds - FY 2016 And Beyond
Change 136 (December 22, 2016)
Baseline (February 1, 2008)
Chap 7 -- Mental Health
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Change 163 (August 14, 2018)
Change 157 (March 6, 2018)
Change 144 (June 13, 2017)
Change 133 (November 2, 2016)
Change 116 (August 31, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 37 (October 20, 2010)
Change 15 (October 9, 2009)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 1 -- Hospital Reimbursement - TRICARE Inpatient Mental Health Per Diem Payment System
Change 195 (April 19, 2021)
Change 188 (December 17, 2020)
Change 182 (March 12, 2020)
Change 181 (December 12, 2019)
Change 174 (June 17, 2019)
Change 170 (February 7, 2019)
Change 157 (March 6, 2018)
Change 147 (August 22, 2017)
Change 144 (June 13, 2017)
Change 141 (March 13, 2017)
Change 133 (November 2, 2016)
Change 128 (April 6, 2016)
Change 125 (February 8, 2016)
Change 116 (August 31, 2015)
Change 115 (August 24, 2015)
Change 108 (December 18, 2014)
Change 97 (June 5, 2014)
Change 92 (December 12, 2013)
Change 87 (September 13, 2013)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Change 61 (January 19, 2012)
Change 58 (November 10, 2011)
Change 51 (July 6, 2011)
Change 37 (October 20, 2010)
Change 20 (November 4, 2009)
Change 15 (October 9, 2009)
Change 13 (September 28, 2009)
Change 5 (May 15, 2009)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 2 -- Partial Hospitalization Program (PHP) And Intensive Outpatient Priogram (IOP) Reimbursement: Mental Health And Substance Use Disorder (SUD) Treatment
Change 149 (October 23, 2017)
Change 144 (June 13, 2017)
Change 126 (February 10, 2016)
Change 123 (January 19, 2016)
Change 116 (August 31, 2015)
Change 68 (May 17, 2012)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 3 -- Substance Use Disorder Rehabilitation Facilities (SUDRFs) Reimbursement
Change 144 (June 13, 2017)
Change 126 (February 10, 2016)
Change 123 (January 19, 2016)
Change 104 (September 23, 2014)
Change 68 (May 17, 2012)
Change 13 (September 28, 2009)
Baseline (February 1, 2008)
Sect 4 -- Residential Treatment Center (RTC) Reimbursement
Change 144 (June 13, 2017)
Change 125 (February 8, 2016)
Change 116 (August 31, 2015)
Baseline (February 1, 2008)
Sect 5 -- Opioid Treatment Programs (OTPs) Reimbursement
Change 144 (June 13, 2017)
Baseline (February 1, 2008)
Addendum A -- Table Of Regional Specific Rates For Psychiatric Hospitals And Units With Low TRICARE Volume - FY 2019 - FY 2021
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Change 157 (March 6, 2018)
Change 133 (November 2, 2016)
Change 116 (August 31, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 37 (October 20, 2010)
Change 27 (March 18, 2010)
Change 15 (October 9, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Addendum B -- Guidelines For The Calculation Of Individual Psychiatric Residential Treatment Center (RTC) Per Diem Rates
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Change 163 (August 14, 2018)
Change 144 (June 13, 2017)
Change 133 (November 2, 2016)
Change 116 (August 31, 2015)
Change 115 (August 24, 2015)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 37 (October 20, 2010)
Change 27 (March 18, 2010)
Change 15 (October 9, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Chap 8 -- Skilled Nursing Facilities (SNFs)
Change 181 (December 12, 2019)
Change 168 (January 14, 2019)
Change 154 (January 29, 2018)
Change 135 (December 20, 2016)
Change 120 (December 7, 2015)
Change 109 (January 8, 2015)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 39 (December 3, 2010)
Change 14 (September 30, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 1 -- Skilled Nursing Facility (SNF) Reimbursement
Change 178 (September 19, 2019)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Sect 2 -- Skilled Nursing Facility (SNF) Prospective Payment System (PPS) For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Change 178 (September 19, 2019)
Change 148 (October 19, 2017)
Change 137 (December 29, 2016)
Change 136 (December 22, 2016)
Change 109 (January 8, 2015)
Change 70 (July 27, 2012)
Change 50 (June 27, 2011)
Change 39 (December 3, 2010)
Change 14 (September 30, 2009)
Change 12 (September 18, 2009)
Change 2 (May 15, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 3 -- Skilled Nursing Facility (SNF) Prospective Payment System (PPS) For Care Rendered On Or After October 1, 2019
Change 187 (October 15, 2020)
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum A -- Letter To Skilled Nursing Facility (SNF) Regarding Participation Agreement For Services Received On Or After October 1, 2019
Change 181 (December 12, 2019)
Change 50 (June 27, 2011)
Change 39 (December 3, 2010)
Baseline (February 1, 2008)
Addendum B -- Letter To Skilled Nursing Facility (SNF) Regarding Participation Agreement For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum C -- Resource Utilization Group-III /IV (RUG-III/IV) For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum D -- Example Of Computation of Adjusted Prospective Payment System (PPS) Rates And Skilled Nursing Facility (SNF) Payment - FY 2018 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Change 161 (July 2, 2018)
Change 154 (January 29, 2018)
Baseline (February 1, 2008)
Addendum D -- Example Of Computation of Adjusted Prospective Payment System (PPS) Rates And Skilled Nursing Facility (SNF) Payment - FY 2019
Change 181 (December 12, 2019)
Change 168 (January 14, 2019)
Baseline (February 1, 2008)
Addendum E -- Fact Sheet Regarding Consolidated Billing and Ambulance Services For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum F -- Case-Mix Adjusted Federal Rates For Service Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Change 154 (January 29, 2018)
Baseline (February 1, 2008)
Addendum F -- Case-Mix Adjusted Federal Rates For Skilled Nursing Facilities (SNFs) - FY 2019 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Change 168 (January 14, 2019)
Baseline (February 1, 2008)
Addendum G -- Wage Indexes For Urban Areas For Skilled Nursing Facilities (SNFs) Based On Core-Based Statistical Area (CBSA) Labor Market Areas - FY 2018 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum G -- Wage Indexes For Urban Areas For Skilled Nursing Facilities (SNFs) Based On Core-Based Statistical Area (CBSA) Labor Market Areas - FY 2019 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum H -- Wage Indexes For Rural Areas For Skilled Nursing Facilities (SNFs) Based On Core-Based Statistical Area (CBSA) Labor Market Areas - FY 2018 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum H -- Wage Indexes For Rural Areas For Skilled Nursing Facilities (SNFs) Based On Core-Based Statistical Area (CBSA) Labor Market Areas - FY 2019 For Services Received Prior To October 1, 2019
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Chap 9 -- Ambulatory Surgery Centers (ASCs)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 1 -- ASC Reimbursement Before May 1, 2009 (Implementation Of OPPS), And Thereafter, Freestanding ASCs, And Non-OPPS Facilities Reimbursement
Change 195 (April 19, 2021)
Change 182 (March 12, 2020)
Change 174 (June 17, 2019)
Change 163 (August 14, 2018)
Change 155 (February 5, 2018)
Change 147 (August 22, 2017)
Change 139 (February 13, 2017)
Change 138 (January 26, 2017)
Change 128 (April 6, 2016)
Change 117 (September 8, 2015)
Change 108 (December 18, 2014)
Change 97 (June 5, 2014)
Change 94 (March 31, 2014)
Change 79 (April 4, 2013)
Change 58 (November 10, 2011)
Change 26 (March 12, 2010)
Change 23 (December 8, 2009)
Change 12 (September 18, 2009)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Chap 10 -- Birthing Centers
Change 170 (February 7, 2019)
Change 146 (August 1, 2017)
Change 129 (June 14, 2016)
Change 115 (August 24, 2015)
Change 99 (June 26, 2014)
Change 81 (June 17, 2013)
Change 69 (May 23, 2012)
Change 47 (April 6, 2011)
Change 33 (August 4, 2010)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 1 -- Freestanding And Hospital-Based Birthing Center Reimbursement
Change 170 (February 7, 2019)
Change 156 (February 20, 2018)
Change 7 (May 28, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Addendum A -- Birthing Center Rate Non-Professional Component
Change 170 (February 7, 2019)
Change 146 (August 1, 2017)
Change 129 (June 14, 2016)
Change 115 (August 24, 2015)
Change 99 (June 26, 2014)
Change 81 (June 17, 2013)
Change 69 (May 23, 2012)
Change 47 (April 6, 2011)
Change 33 (August 4, 2010)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Chap 11 -- Hospice
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 176 (August 5, 2019)
Change 170 (February 7, 2019)
Change 157 (March 6, 2018)
Change 136 (December 22, 2016)
Change 126 (February 10, 2016)
Change 108 (December 18, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 38 (October 29, 2010)
Change 24 (December 31, 2009)
Change 20 (November 4, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 1 -- Hospice Reimbursement - General Overview
Change 176 (August 5, 2019)
Change 170 (February 7, 2019)
Change 148 (October 19, 2017)
Change 136 (December 22, 2016)
Change 126 (February 10, 2016)
Change 108 (December 18, 2014)
Change 94 (March 31, 2014)
Change 92 (December 12, 2013)
Change 75 (November 26, 2012)
Change 58 (November 10, 2011)
Change 38 (October 29, 2010)
Change 24 (December 31, 2009)
Change 20 (November 4, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Sect 2 -- Hospice Reimbursement - Coverage/Benefits
Change 198 (September 2, 2021)
Change 118 (November 20, 2015)
Baseline (February 1, 2008)
Sect 3 -- Hospice Reimbursement - Conditions For Coverage
Change 176 (August 5, 2019)
Change 164 (September 13, 2018)
Change 157 (March 6, 2018)
Change 103 (September 22, 2014)
Change 85 (August 22, 2013)
Change 71 (August 24, 2012)
Baseline (February 1, 2008)
Sect 4 -- Hospice Reimbursement - Guidelines For Payment Of Designated Levels Of Care
Change 188 (December 17, 2020)
Change 181 (December 12, 2019)
Change 178 (September 19, 2019)
Change 176 (August 5, 2019)
Change 170 (February 7, 2019)
Change 164 (September 13, 2018)
Change 157 (March 6, 2018)
Change 148 (October 19, 2017)
Change 136 (December 22, 2016)
Change 126 (February 10, 2016)
Change 118 (November 20, 2015)
Change 108 (December 18, 2014)
Change 103 (September 22, 2014)
Change 94 (March 31, 2014)
Change 92 (December 12, 2013)
Change 85 (August 22, 2013)
Change 75 (November 26, 2012)
Change 71 (August 24, 2012)
Change 58 (November 10, 2011)
Change 38 (October 29, 2010)
Change 24 (December 31, 2009)
Change 20 (November 4, 2009)
Change 11 (August 10, 2009)
Baseline (February 1, 2008)
Sect 5 -- Hospice Reimbursement - Concurrent Hospice Services and Curative Care For Pediatric Beneficiaries
Change 176 (August 5, 2019)
Baseline (February 1, 2008)
Addendum A -- Hospice Care Rates - FY 2019
Change 174 (June 17, 2019)
Change 170 (February 7, 2019)
Baseline (February 1, 2008)
Addendum A -- Hospice Care Rates - FY 2020
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum A -- Hospice Care Rates - FY 2021
Change 188 (December 17, 2020)
Baseline (February 1, 2008)
Addendum B -- Hospice Rate Information - Hospice Wage Indexes For Urban Areas - FY 2019
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Baseline (February 1, 2008)
Addendum B -- Hospice Rate Information - Hospice Wage Indexes For Urban Areas - FY 2020
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum B -- Hospice Rate Information - Hospice Wage Indexes For Urban Areas - FY 2021
Change 188 (December 17, 2020)
Baseline (February 1, 2008)
Addendum C -- Hospice Rate Information - Hospice Wage Indexes For Rural Areas - FY 2019
Change 181 (December 12, 2019)
Change 170 (February 7, 2019)
Baseline (February 1, 2008)
Addendum C -- Hospice Rate Information - Hospice Wage Indexes For Rural Areas - FY 2020
Change 181 (December 12, 2019)
Baseline (February 1, 2008)
Addendum C -- Hospice Rate Information - Hospice Wage Indexes For Rural Areas - FY 2021
Change 188 (December 17, 2020)
Baseline (February 1, 2008)
Addendum D -- Participation Agreement For Hospice Program Services For TRICARE Beneficiaries
Baseline (February 1, 2008)
Chap 12 -- Home Health Care (HHC)
Change 195 (April 19, 2021)
Change 183 (March 25, 2020)
Change 174 (June 17, 2019)
Change 162 (August 8, 2018)
Change 148 (October 19, 2017)
Change 145 (June 29, 2017)
Change 128 (April 6, 2016)
Change 112 (March 23, 2015)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Change 49 (June 3, 2011)
Change 42 (February 3, 2011)
Change 32 (August 2, 2010)
Change 9 (June 10, 2009)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Sect 1 -- Home Health Benefit Coverage And Reimbursement - General Overview
Change 195 (April 19, 2021)
Change 183 (March 25, 2020)
Change 174 (June 17, 2019)
Change 169 (January 30, 2019)
Change 162 (August 8, 2018)
Change 148 (October 19, 2017)
Change 145 (June 29, 2017)
Change 128 (April 6, 2016)
Change 116 (August 31, 2015)
Change 112 (March 23, 2015)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Change 49 (June 3, 2011)
Change 32 (August 2, 2010)
Change 9 (June 10, 2009)
Change 4 (November 7, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 2 -- Home Health Care (HHC) - Benefits And Conditions For Coverage
Change 183 (March 25, 2020)
Change 148 (October 19, 2017)
Change 118 (November 20, 2015)
Change 112 (March 23, 2015)
Change 94 (March 31, 2014)
Change 88 (September 14, 2013)
Change 73 (September 24, 2012)
Change 56 (September 26, 2011)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Sect 3 -- Home Health Benefit Coverage And Reimbursement - Assessment Process
Change 183 (March 25, 2020)
Change 112 (March 23, 2015)
Change 49 (June 3, 2011)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 4 -- Home Health Benefit Coverage And Reimbursement - Prospective Payment Methodology
Change 199 (December 22, 2021)
Change 195 (April 19, 2021)
Change 183 (March 25, 2020)
Change 174 (June 17, 2019)
Change 162 (August 8, 2018)
Change 148 (October 19, 2017)
Change 145 (June 29, 2017)
Change 137 (December 29, 2016)
Change 128 (April 6, 2016)
Change 117 (September 8, 2015)
Change 116 (August 31, 2015)
Change 112 (March 23, 2015)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Change 57 (September 28, 2011)
Change 49 (June 3, 2011)
Change 32 (August 2, 2010)
Change 9 (June 10, 2009)
Change 4 (November 7, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Sect 5 -- Home Health Benefit Coverage And Reimbursement - Primary Provider Status And Episodes/Periods Of Care
Change 183 (March 25, 2020)
Change 169 (January 30, 2019)
Change 148 (October 19, 2017)
Change 118 (November 20, 2015)
Change 62 (March 16, 2012)
Baseline (February 1, 2008)
Sect 6 -- Home Health Benefit Coverage And Reimbursement - Claims And Billing Submission Under HHA PPS
Change 195 (April 19, 2021)
Change 183 (March 25, 2020)
Change 174 (June 17, 2019)
Change 169 (January 30, 2019)
Change 150 (October 26, 2017)
Change 145 (June 29, 2017)
Change 128 (April 6, 2016)
Change 118 (November 20, 2015)
Change 116 (August 31, 2015)
Change 112 (March 23, 2015)
Change 110 (January 12, 2015)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Change 49 (June 3, 2011)
Change 43 (February 18, 2011)
Baseline (February 1, 2008)
Sect 7 -- Home Health Benefit Coverage And Reimbursement - Pricer Requirements And Logic
Change 183 (March 25, 2020)
Change 174 (June 17, 2019)
Change 162 (August 8, 2018)
Change 145 (June 29, 2017)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Baseline (February 1, 2008)
Sect 8 -- Home Health Benefit Coverage And Reimbursement - Medical Review Requirements
Change 183 (March 25, 2020)
Change 73 (September 24, 2012)
Baseline (February 1, 2008)
Sect 9 -- Home Health Benefit Coverage And Reimbursement - Under The Patient-Driven Groupings Model (PDGM)
Change 195 (April 19, 2021)
Change 183 (March 25, 2020)
Baseline (February 1, 2008)
Addendum A -- Definitions And Acronym Table
Change 169 (January 30, 2019)
Change 137 (December 29, 2016)
Change 94 (March 31, 2014)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Addendum B -- Home Health Resource Group (HHRG) Worksheet
Change 183 (March 25, 2020)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Addendum C -- Annual Home Health Agency Prospective Payment System (HHA PPS) Rate Updates - CY 2019
Change 183 (March 25, 2020)
Baseline (February 1, 2008)
Addendum C -- Annual Home Health Agency Prospective Payment System (HHA PPS) Rate Updates - CY 2020
Change 183 (March 25, 2020)
Baseline (February 1, 2008)
Addendum C -- Annual Home Health Agency Prospective Payment System (HHA PPS) Rate Updates - CY 2021
Change 195 (April 19, 2021)
Baseline (February 1, 2008)
Addendum D -- Home Health Certification And Plan Of Care (POC)
Change 112 (March 23, 2015)
Baseline (February 1, 2008)
Addendum E -- Code Table For Converting Julian Dates To Two Position Alphabetic Values
Change 183 (March 25, 2020)
Baseline (February 1, 2008)
Chap 13 -- Outpatient Prospective Payment System (OPPS)-Ambulatory Payment Classification (APC)
Change 122 (January 12, 2016)
Change 71 (August 24, 2012)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 1 -- General
Change 178 (September 19, 2019)
Change 148 (October 19, 2017)
Change 147 (August 22, 2017)
Change 144 (June 13, 2017)
Change 122 (January 12, 2016)
Change 117 (September 8, 2015)
Change 115 (August 24, 2015)
Change 88 (September 14, 2013)
Change 66 (May 4, 2012)
Change 34 (August 10, 2010)
Change 26 (March 12, 2010)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 2 -- Billing And Coding Of Services Under Ambulatory Payment Classifications (APC) Groups
Change 149 (October 23, 2017)
Change 144 (June 13, 2017)
Change 137 (December 29, 2016)
Change 134 (November 8, 2016)
Change 128 (April 6, 2016)
Change 126 (February 10, 2016)
Change 123 (January 19, 2016)
Change 122 (January 12, 2016)
Change 117 (September 8, 2015)
Change 115 (August 24, 2015)
Change 71 (August 24, 2012)
Change 62 (March 16, 2012)
Change 26 (March 12, 2010)
Change 25 (January 13, 2010)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 3 -- Prospective Payment Methodology
Change 148 (October 19, 2017)
Change 142 (March 23, 2017)
Change 141 (March 13, 2017)
Change 128 (April 6, 2016)
Change 122 (January 12, 2016)
Change 118 (November 20, 2015)
Change 117 (September 8, 2015)
Change 115 (August 24, 2015)
Change 79 (April 4, 2013)
Change 74 (October 16, 2012)
Change 68 (May 17, 2012)
Change 66 (May 4, 2012)
Change 56 (September 26, 2011)
Change 31 (July 20, 2010)
Change 26 (March 12, 2010)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 4 -- Claims Submission And Processing Requirements
Change 128 (April 6, 2016)
Change 122 (January 12, 2016)
Change 26 (March 12, 2010)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Sect 5 -- Medical Review And Allowable Charge Review Under the Outpatient Prospective Payment System (OPPS)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Addendum A -- Development Schedule For TRICARE Outpatient Code Editor (OCE)/Ambulatory Payment Classification (APC) Quarterly Update
Baseline (February 1, 2008)
Addendum B -- Outpatient Prospective Payment System (OPPS) Outpatient Code Editor (OCE) Notification Process For Quarterly Updates
Change 122 (January 12, 2016)
Baseline (February 1, 2008)
Addendum C -- Approval of OPPS - OCE/APC And NGPL Quarterly Update Process
Change 122 (January 12, 2016)
Change 7 (May 28, 2009)
Baseline (February 1, 2008)
Chap 14 -- Sole Community Hospitals (SCHs)
Baseline (February 1, 2008)
Sect 1 -- Sole Community Hospitals (SCHs)
Change 181 (December 12, 2019)
Change 174 (June 17, 2019)
Change 147 (August 22, 2017)
Change 142 (March 23, 2017)
Change 140 (March 9, 2017)
Change 137 (December 29, 2016)
Change 131 (July 19, 2016)
Change 101 (July 23, 2014)
Change 87 (September 13, 2013)
Baseline (February 1, 2008)
Chap 15 -- Critical Access Hospitals (CAHs)
Baseline (February 1, 2008)
Sect 1 -- Critical Access Hospitals (CAHs)
Change 198 (September 2, 2021)
Change 142 (March 23, 2017)
Change 137 (December 29, 2016)
Change 114 (August 19, 2015)
Change 101 (July 23, 2014)
Change 97 (June 5, 2014)
Change 94 (March 31, 2014)
Change 88 (September 14, 2013)
Change 87 (September 13, 2013)
Change 86 (September 11, 2013)
Change 79 (April 4, 2013)
Change 61 (January 19, 2012)
Change 60 (January 11, 2012)
Change 40 (December 23, 2010)
Change 22 (December 2, 2009)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Chap 16 -- Long-Term Care Hospitals (LTCHs)
Change 159 (May 23, 2018)
Baseline (February 1, 2008)
Sect 1 -- Long-Term Care Hospitals (LTCHs)
Change 178 (September 19, 2019)
Change 166 (November 5, 2018)
Change 159 (May 23, 2018)
Baseline (February 1, 2008)
Chap 17 -- Inpatient Rehabilitation Facilities (IRFs)
Change 159 (May 23, 2018)
Baseline (February 1, 2008)
Sect 1 -- Inpatient Rehabilitation Facilities (IRFs)
Change 178 (September 19, 2019)
Change 171 (February 19, 2019)
Change 166 (November 5, 2018)
Change 159 (May 23, 2018)
Baseline (February 1, 2008)
Acronyms And Abbreviations
Change 191 (February 2, 2021)
Change 181 (December 12, 2019)
Change 179 (September 26, 2019)
Change 178 (September 19, 2019)
Change 176 (August 5, 2019)
Change 173 (March 18, 2019)
Change 171 (February 19, 2019)
Change 170 (February 7, 2019)
Change 167 (January 3, 2019)
Change 159 (May 23, 2018)
Change 144 (June 13, 2017)
Change 139 (February 13, 2017)
Change 136 (December 22, 2016)
Change 134 (November 8, 2016)
Change 131 (July 19, 2016)
Change 130 (June 17, 2016)
Change 129 (June 14, 2016)
Change 128 (April 6, 2016)
Change 125 (February 8, 2016)
Change 118 (November 20, 2015)
Change 115 (August 24, 2015)
Change 113 (August 12, 2015)
Change 111 (March 12, 2015)
Change 107 (December 10, 2014)
Change 106 (November 4, 2014)
Change 105 (October 23, 2014)
Change 104 (September 23, 2014)
Change 102 (August 22, 2014)
Change 101 (July 23, 2014)
Change 97 (June 5, 2014)
Change 96 (May 19, 2014)
Change 94 (March 31, 2014)
Change 93 (December 20, 2013)
Change 89 (September 19, 2013)
Change 88 (September 14, 2013)
Change 87 (September 13, 2013)
Change 82 (July 11, 2013)
Change 81 (June 17, 2013)
Change 79 (April 4, 2013)
Change 77 (December 17, 2012)
Change 75 (November 26, 2012)
Change 72 (September 21, 2012)
Change 71 (August 24, 2012)
Change 70 (July 27, 2012)
Change 67 (May 7, 2012)
Change 66 (May 4, 2012)
Change 65 (April 27, 2012)
Change 63 (April 6, 2012)
Change 62 (March 16, 2012)
Change 60 (January 11, 2012)
Change 59 (December 7, 2011)
Change 57 (September 28, 2011)
Change 54 (September 21, 2011)
Change 50 (June 27, 2011)
Change 49 (June 3, 2011)
Change 47 (April 6, 2011)
Change 46 (April 4, 2011)
Change 45 (March 11, 2011)
Change 44 (March 2, 2011)
Change 42 (February 3, 2011)
Change 41 (January 31, 2011)
Change 39 (December 3, 2010)
Change 35 (September 10, 2010)
Change 34 (August 10, 2010)
Change 32 (August 2, 2010)
Change 25 (January 13, 2010)
Change 24 (December 31, 2009)
Change 21 (November 10, 2009)
Change 19 (October 29, 2009)
Change 18 (October 23, 2009)
Change 17 (October 20, 2009)
Change 13 (September 28, 2009)
Change 12 (September 18, 2009)
Change 11 (August 10, 2009)
Change 7 (May 28, 2009)
Change 4 (November 7, 2008)
Change 3 (June 10, 2008)
Change 2 (May 15, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Index
Change 195 (April 19, 2021)
Change 194 (April 8, 2021)
Change 191 (February 2, 2021)
Change 190 (January 7, 2021)
Change 189 (December 23, 2020)
Change 188 (December 17, 2020)
Change 183 (March 25, 2020)
Change 181 (December 12, 2019)
Change 179 (September 26, 2019)
Change 176 (August 5, 2019)
Change 174 (June 17, 2019)
Change 173 (March 18, 2019)
Change 172 (March 11, 2019)
Change 170 (February 7, 2019)
Change 168 (January 14, 2019)
Change 162 (August 8, 2018)
Change 159 (May 23, 2018)
Change 157 (March 6, 2018)
Change 154 (January 29, 2018)
Change 152 (November 29, 2017)
Change 148 (October 19, 2017)
Change 145 (June 29, 2017)
Change 144 (June 13, 2017)
Change 136 (December 22, 2016)
Change 135 (December 20, 2016)
Change 133 (November 2, 2016)
Change 128 (April 6, 2016)
Change 126 (February 10, 2016)
Change 123 (January 19, 2016)
Change 120 (December 7, 2015)
Change 119 (December 4, 2015)
Change 118 (November 20, 2015)
Change 116 (August 31, 2015)
Change 112 (March 23, 2015)
Change 109 (January 8, 2015)
Change 108 (December 18, 2014)
Change 97 (June 5, 2014)
Change 96 (May 19, 2014)
Change 92 (December 12, 2013)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Change 70 (July 27, 2012)
Change 65 (April 27, 2012)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Change 49 (June 3, 2011)
Change 46 (April 4, 2011)
Change 44 (March 2, 2011)
Change 39 (December 3, 2010)
Change 38 (October 29, 2010)
Change 37 (October 20, 2010)
Change 32 (August 2, 2010)
Change 28 (July 8, 2010)
Change 24 (December 31, 2009)
Change 21 (November 10, 2009)
Change 20 (November 4, 2009)
Change 19 (October 29, 2009)
Change 16 (October 16, 2009)
Change 15 (October 9, 2009)
Change 14 (September 30, 2009)
Change 12 (September 18, 2009)
Change 9 (June 10, 2009)
Change 7 (May 28, 2009)
Change 5 (May 15, 2009)
Change 2 (May 15, 2008)
Baseline (February 1, 2008)
Obsolete Files
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Change 49 (June 3, 2011)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 1 (March 13, 2008)
Baseline (February 1, 2008)
Change 49 (June 3, 2011)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Change 49 (June 3, 2011)
Change 4 (November 7, 2008)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 9 (June 10, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 17 (October 20, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 17 (October 20, 2009)
Change 5 (May 15, 2009)
Baseline (February 1, 2008)
Change 9 (June 10, 2009)
Baseline (February 1, 2008)
Change 32 (August 2, 2010)
Change 9 (June 10, 2009)
Baseline (February 1, 2008)
Change 9 (June 10, 2009)
Baseline (February 1, 2008)
Change 12 (September 18, 2009)
Baseline (February 1, 2008)
Change 14 (September 30, 2009)
Baseline (February 1, 2008)
Change 14 (September 30, 2009)
Baseline (February 1, 2008)
Change 39 (December 3, 2010)
Change 15 (October 9, 2009)
Change 14 (September 30, 2009)
Baseline (February 1, 2008)
Change 14 (September 30, 2009)
Baseline (February 1, 2008)
Change 74 (October 16, 2012)
Change 63 (April 6, 2012)
Change 37 (October 20, 2010)
Change 34 (August 10, 2010)
Change 15 (October 9, 2009)
Baseline (February 1, 2008)
Change 20 (November 4, 2009)
Change 16 (October 16, 2009)
Baseline (February 1, 2008)
Change 20 (November 4, 2009)
Change 16 (October 16, 2009)
Baseline (February 1, 2008)
Change 20 (November 4, 2009)
Baseline (February 1, 2008)
Change 20 (November 4, 2009)
Baseline (February 1, 2008)
Change 24 (December 31, 2009)
Baseline (February 1, 2008)
Change 32 (August 2, 2010)
Baseline (February 1, 2008)
Change 42 (February 3, 2011)
Change 32 (August 2, 2010)
Baseline (February 1, 2008)
Change 57 (September 28, 2011)
Change 32 (August 2, 2010)
Baseline (February 1, 2008)
Change 74 (October 16, 2012)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Change 37 (October 20, 2010)
Baseline (February 1, 2008)
Change 38 (October 29, 2010)
Baseline (February 1, 2008)
Change 57 (September 28, 2011)
Change 38 (October 29, 2010)
Baseline (February 1, 2008)
Change 38 (October 29, 2010)
Baseline (February 1, 2008)
Change 39 (December 3, 2010)
Baseline (February 1, 2008)
Change 39 (December 3, 2010)
Baseline (February 1, 2008)
Change 50 (June 27, 2011)
Change 39 (December 3, 2010)
Baseline (February 1, 2008)
Change 39 (December 3, 2010)
Baseline (February 1, 2008)
Change 44 (March 2, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Change 44 (March 2, 2011)
Baseline (February 1, 2008)
Change 116 (August 31, 2015)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 117 (September 8, 2015)
Change 63 (April 6, 2012)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 116 (August 31, 2015)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 169 (January 30, 2019)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 49 (June 3, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Change 74 (October 16, 2012)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 63 (April 6, 2012)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 58 (November 10, 2011)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Change 63 (April 6, 2012)
Baseline (February 1, 2008)
Change 63 (April 6, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 99 (June 26, 2014)
Change 92 (December 12, 2013)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 75 (November 26, 2012)
Baseline (February 1, 2008)
Change 79 (April 4, 2013)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Change 79 (April 4, 2013)
Baseline (February 1, 2008)
Change 80 (May 14, 2013)
Change 79 (April 4, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 115 (August 24, 2015)
Change 99 (June 26, 2014)
Change 97 (June 5, 2014)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 92 (December 12, 2013)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Baseline (February 1, 2008)
Change 97 (June 5, 2014)
Baseline (February 1, 2008)
Change 115 (August 24, 2015)
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Change 108 (December 18, 2014)
Baseline (February 1, 2008)
Change 109 (January 8, 2015)
Baseline (February 1, 2008)
Change 109 (January 8, 2015)
Baseline (February 1, 2008)
Change 109 (January 8, 2015)
Baseline (February 1, 2008)
Change 109 (January 8, 2015)
Baseline (February 1, 2008)
Change 128 (April 6, 2016)
Change 112 (March 23, 2015)
Baseline (February 1, 2008)
Change 128 (April 6, 2016)
Change 117 (September 8, 2015)
Change 112 (March 23, 2015)
Baseline (February 1, 2008)
Change 119 (December 4, 2015)
Baseline (February 1, 2008)
Change 119 (December 4, 2015)
Baseline (February 1, 2008)
Change 120 (December 7, 2015)
Baseline (February 1, 2008)
Change 120 (December 7, 2015)
Baseline (February 1, 2008)
Change 120 (December 7, 2015)
Baseline (February 1, 2008)
Change 120 (December 7, 2015)
Baseline (February 1, 2008)
Change 136 (December 22, 2016)
Change 126 (February 10, 2016)
Baseline (February 1, 2008)
Change 126 (February 10, 2016)
Baseline (February 1, 2008)
Change 126 (February 10, 2016)
Baseline (February 1, 2008)
Change 128 (April 6, 2016)
Baseline (February 1, 2008)
Change 135 (December 20, 2016)
Baseline (February 1, 2008)
Change 135 (December 20, 2016)
Baseline (February 1, 2008)
Change 135 (December 20, 2016)
Baseline (February 1, 2008)
Change 135 (December 20, 2016)
Baseline (February 1, 2008)
Change 136 (December 22, 2016)
Baseline (February 1, 2008)
Change 136 (December 22, 2016)
Baseline (February 1, 2008)
Change 136 (December 22, 2016)
Baseline (February 1, 2008)
Change 178 (September 19, 2019)
Change 137 (December 29, 2016)
Baseline (February 1, 2008)
Change 145 (June 29, 2017)
Baseline (February 1, 2008)
Change 174 (June 17, 2019)
Change 162 (August 8, 2018)
Change 145 (June 29, 2017)
Baseline (February 1, 2008)
Change 161 (July 2, 2018)
Change 154 (January 29, 2018)
Baseline (February 1, 2008)
Change 154 (January 29, 2018)
Baseline (February 1, 2008)
Change 157 (March 6, 2018)
Baseline (February 1, 2008)
Change 157 (March 6, 2018)
Baseline (February 1, 2008)
Change 157 (March 6, 2018)
Baseline (February 1, 2008)
Change 162 (August 8, 2018)
Baseline (February 1, 2008)
Change 168 (January 14, 2019)
Baseline (February 1, 2008)
Change 168 (January 14, 2019)
Baseline (February 1, 2008)
Change 174 (June 17, 2019)
Baseline (February 1, 2008)
Change 178 (September 19, 2019)
Baseline (February 1, 2008)
Change 183 (March 25, 2020)
Baseline (February 1, 2008)
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