TRICARE Manuals - Display Chap 7 Addendum A (Change 49, Jun 9, 2020)

Mental Health

Chapter 7

Addendum A

Table Of Regional Specific Rates For Psychiatric Hospitals And Units With Low TRICARE Volume - FY 2018 - FY 2020

Revision: C-44, December 13, 2019

United States Census Regions	FY 2018 Regional Rates 10/01/17 - 09/30/18	FY 2019 Regional Rates 10/01/18 - 09/30/19	FY 2020 Regional Rates 10/01/19 - 09/30/20
Northeast:
New England (ME, NH, VT, MA, RI, CT)	$919	$946	$974
Mid-Atlantic (NY, NJ, PA)	$886	$912	$939
Midwest:
East North Central (OH, IN, IL, MI, WI)	$766	$788	$812
West North Central (MN, IA, MO, ND, SD, NE, KS)	$722	$743	$765
South:
South Atlantic (DE, MD, DC, VA, WV, NC, SC, GA, FL)	$911	$937	$965
East South Central (KY, TN, AL, MS)	$975	$1003	$1033
West South Central (AR, LA, TX, OK)	$830	$854	$880
West:
Mountain (MT, ID, WY, CO, NM, AZ, UT, NV)	$829	$853	$879
Pacific (WA, OR, CA, AK, HI)	$981	$1009	$1039
Puerto Rico	$625	$643	$662

Note: This table reflects maximum rates.

For FYs 2018 through 2020: For wage index values greater than 1.0, the wage portion or labor related share subject to the area wage adjustment is 68.3%. The non-labor related share is 31.7%. For wage index values less than or equal to 1.0, the wage portion or labor related share subject to the area wage adjustment is 62%. The non-labor related share is 38%. Utilize the appropriate year DRG wage index file for area wage adjustment calculations.

For FY 2018/Beneficiary Cost-Share: Beneficiary cost-share (other than active duty members) for care paid on a basis of a regional per diem rate is the lower of $241 per day or 25% of the hospital billed charges effective for services rendered on or after October 1, 2017.

For FY 2019/Beneficiary Cost-Share: Beneficiary cost-share (other than active duty members) for care paid on a basis of a regional per diem rate is the lower of $248 per day or 25% of the hospital billed charges effective for services rendered on or after October 1, 2018.

For FY 2020/Beneficiary Cost-Share: Beneficiary cost-share (other than active duty members) for care paid on a basis of a regional per diem rate is the lower of $255 per day or 25% of the hospital billed charges effective for services rendered on or after October 1, 2019.

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