TRICARE Reimbursement Manual 6010.64-M, April 2021Chap 1GeneralRevision: C-0, Dec 5, 2022Section/Addendum Subject/Addendum Title1Network Provider Reimbursement2Accommodation Of Discounts Under Provider Reimbursement Methods3Claims Auditing Software4Reimbursement In Teaching Setting5National Health Service Corps (NHSC) Physicians Of The Public Health Service (PHS)6Reimbursement Of Physician Assistants (PAs), Nurse Practitioners (NPs), And Certified Psychiatric Nurse Specialists (CPNSs)7Reimbursement Of Covered Services Provided By Individual Health Care Providers And Other Non-Institutional Health Care Providers8Economic Interest In Connection With Mental Health Admissions9Anesthesia10Postoperative Pain Management - Epidural Analgesia11Claims For Durable Equipment (DE) And Durable Medical Equipment, Prosthetics, Orthotics, And Supplies (DMEPOS)12Oxygen And Related Supplies13Laboratory Services14Ambulance Services15Legend Drugs And Insulin16Surgery17Assistant Surgeons18Professional Services: Obstetrical Care19Charges For Provider Administrative Expenses20State Agency Billing21Hospital Reimbursement - Billed Charges Set Rates22Hospital Reimbursement - Other Than Billed Charges23Hospital Reimbursement - Payment When Only Skilled Nursing Facility (SNF) Level Of Care Is Required24Hospital Reimbursement - Outpatient Services25Preferred Provider Organization (PPO) Reimbursement26Supplemental Insurance27Legal Obligation To Pay28Reduction Of Payment For Noncompliance With Utilization Review Requirements29Reimbursement Of Emergency Inpatient Admissions To Unauthorized Facilities30Reimbursement Of Travel Expenses For Specialty Care31Newborn Charges32Hospital-Based Birthing Room33Bonus Payments In Health Professional Shortage Areas (HPSAs) 34Hospital Inpatient Reimbursement In Locations Outside The 50 United States (US) And The District Of Columbia35Professional Provider Reimbursement In Specified Locations Outside The 50 United States (US) And The District Of Columbia36Forensic Examinations Following Sexual Assault or Domestic Violence37Medical Errors38Reimbursement of State Vaccine Programs (SVPs)39CHAMPUS Maximum Allowable Charge (CMAC) For Banked Donor Milk (BDM)40Organ Acquisition Costs41Hospital Reimbursement - Hospital Value-Based Purchasing (HVBP)42Temporary Reimbursement Changes In Response To The Coronavirus Disease 2019 (COVID-19) PandemicASample State Agency Billing AgreementBFiguresCMinimum Requirements For Reimbursement Of Per Capita State (Or Alternative) State Vaccine Programs (SVPs)DMaximum Allowable Charge For Breastfeeding Supplies