Skip to main content

Military Health System

Utility Navigation Links

TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
Mental Health
Chapter 7
Addendum A
Table Of Regional Specific Rates For Psychiatric Hospitals And Units With Low TRICARE Volume - FY 2019 - FY 2021
Revision:  C-51, December 18, 2020
United States Census Regions
FY 2019
Regional Rates
10/01/18 - 09/30/19
FY 2020
Regional Rates
10/01/19 - 09/30/20
FY 2021
Regional Rates
10/01/20 - 09/30/21
Northeast:
New England
(ME, NH, VT, MA, RI, CT)
$946
$974
$997
Mid-Atlantic
(NY, NJ, PA)
$912
$939
$962
Midwest:
East North Central
(OH, IN, IL, MI, WI)
$788
$812
$831
West North Central
(MN, IA, MO, ND, SD, NE, KS)
$743
$765
$783
South:
South Atlantic
(DE, MD, DC, VA, WV, NC, SC, GA, FL)
$937
$965
$988
East South Central
(KY, TN, AL, MS)
$1003
$1033
$1058
West South Central
(AR, LA, TX, OK)
$854
$880
$901
West:
Mountain
(MT, ID, WY, CO, NM, AZ, UT, NV)
$853
$879
$900
Pacific
(WA, OR, CA, AK, HI)
$1009
$1039
$1064
Puerto Rico
$643
$662
$678
Note:  This table reflects maximum rates.
For FYs 2019 through 2021: 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 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.
For FY 2021/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 $261 per day or 25% of the hospital billed charges effective for services rendered on or after October 1, 2020.
- END -
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery