Back to Top Skip to main content

Health.mil: the official website of the Military Health System (MHS) and the Defense Health Agency (DHA)

Utility Navigation Links

TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
General
Chapter 1
Section 34
Hospital Inpatient Reimbursement In Locations Outside The 50 United States (U.S.) And The District Of Columbia
Issue Date:  September 9, 2004
Authority:  32 CFR 199.1(b) and 32 CFR 199.14(m), (n), and (o)
Revision:  C-45, March 13, 2020
1.0  APPLICABILITY
This policy is mandatory for reimbursement of all hospital inpatient services provided in the locations identified in paragraph 4.2. This policy revises, replaces, and supersedes the previously issued policy, effective October 1, 2004, for hospital reimbursement in the Philippines. Puerto Rico follows Continental United States (CONUS) based reimbursement methodologies used for the 50 U.S. and the District of Columbia.
2.0  ISSUE
How are specified inpatient hospital services reimbursed in the locations specified in paragraph 4.2?
3.0  POLICY
The institutional per diem for those specified locations outside the 50 U.S. and the District of Columbia is the maximum amount TRICARE will authorize to be paid for inpatient services on a per diem basis. The allowable institutional rates for those specified locations outside the 50 U.S. and the District of Columbia, shall be the lesser of (a) billed charges or; (b) the amount based on prospectively determined per diems which are adjusted by a country specific index factor.
4.0  BACKGROUND
Reimbursement Systems:
4.1  General
4.1.1  Payment for inpatient hospital stays in specified locations outside the 50 U.S. and the District of Columbia, are made utilizing the lesser of:
•  Billed charges; or
•  The prospectively determined per diems adjusted by a country specific index.
4.1.2  The prospectively determined per diem rates for specified locations outside the 50 U.S. and the District of Columbia, are developed into reimbursement groupings by utilizing diagnosis codes. For services provided before the mandated date, as directed by Health and Human Services (HHS), for International Classification of Diseases, 10th Revision (ICD-10) implementation, use diagnosis codes as contained in the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). For services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation, use diagnosis codes as contained in the ICD-10-CM. The per diem rates are the maximum allowable amounts that TRICARE shall reimburse and the amount on which patient cost-shares are calculated. The National U.S. per diem rate is multiplied by a unique country specific index factor which adjusts the National U.S. per diems for the applicable country. The country specific hospital per diem, for those specified locations outside the 50 U.S. and the District of Columbia is the product of the National U.S. per diem and the country specific index.
4.2  Applicability
4.2.1  This payment system applies to all hospitals providing services in:
•  The Philippines.
•  Panama.
•  Other as designated by the Government.
4.2.2  This payment system will be applied by the foreign claims processor. It applies to hospital inpatient services furnished to retirees or their eligible family members or non-Prime Active Duty Family Members (ADFMs) falling under the claims processing jurisdiction of the foreign claims processor.
4.2.3  Institutional providers accepting, admitting and treating TRICARE beneficiaries will receive the per diem reimbursement on applicable hospital services included on inpatient claims. This payment system is to be used regardless of the type of hospital inpatient services provided. The prospectively determined per diem rates established under this system are all-inclusive and are intended to include, but not be limited to, a standard amount for nursing and technician services; room, board and meals; drugs including any take home drugs; biologicals; surgical dressings, splints, casts; Durable Medical Equipment (DME) for use in the hospital and is related to the provision of a surgical service, procedure or procedures, equipment related to the provision and performance of surgical procedures; laboratory services and testing; X-ray or other diagnostic procedures directly related to the inpatient Episode Of Care (EOC); special unit operating costs, such as intensive care units; malpractice costs, if applicable, or other administrative costs related to the services furnished to the patients, recordkeeping and the provision of records; housekeeping items and services; and capital costs.
4.2.4  The per diem rates do not include such items as physicians’ fees, irrespective of a physician’s employment status with the hospital. The per diem rates do not include other professional providers (e.g., nurse anesthetist) recognized by TRICARE who render directly related inpatient services and bill independently from the hospital for them. A valid primary ICD-9-CM code or narrative description of services must be submitted by the hospital or institutional provider for services provided before the mandated date, as directed by HHS, for ICD-10 implementation. A valid primary ICD-10-CM code or narrative description of services must be submitted by the hospital or institutional provider for services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation. The medical description provided shall be able to support development of the claim by the overseas claims processor prior to reimbursement.
4.3  Country Specific Index
The country specific index is a factor obtained from the World Bank’s International Comparison Program. The index factor, known as Purchasing Power Parity (PPP) conversion factor, is based on a large array of goods and services or market basket within the specific country which is then standardized and weighted to a U.S. standard and currency. The World Bank defines PPP conversion factor as: “Number of units of a country’s currency required to buy the same amount of goods and services in the domestic market that a U.S. dollar would buy in the U.S.” The use of the country specific index enables a conversion and therefore creates parity between the U.S. and the specific country in the purchasing of the same amount and type of medical services. TRICARE is utilizing the World Bank’s International Comparison Program country specific index as provided in Figure 1.34-1.
4.4  Institutional Payment Rates
4.4.1  For services provided before the mandated date, as directed by HHS, for ICD-10 implementation:
National per diems are included in Figure 1.34-2 and Figure 1.34-3. The figures contain the ICD-9-CM code, code range, or groups of related diagnosis codes. The first three digits of the principal ICD-9-CM diagnosis code determines placement into a diagnosis group as well as a reimbursement group. The adjusted per diems will be available at: http://www.health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Foreign-Rates.
4.4.2  For services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation:
National per diems are included in Figure 1.34-2. The figures contain the ICD-10-CM code, code range, or groups of related diagnosis codes. The first alpha character and two digits of the principal ICD-10-CM diagnosis code determines placement into a diagnosis group as well as a reimbursement group. The adjusted per diems will be available at: http://www.health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Foreign-Rates.
4.4.3  The rate setting methodology was developed as follows:
4.4.3.1  For services provided before the mandated date, as directed by HHS, for ICD-10 implementation:
•  A rate setting methodology utilizing the first three digits of a primary diagnosis code.
•  Eighteen diagnosis groupings were defined and designed based on the groupings and definitions contained in the ICD-9-CM publication. For example, Group 1 is defined as ICD-9-CM codes 001 to 139, or Infectious and Parasitic Diseases. The first three digits of a primary diagnosis code are utilized for placement into one of the 18 groups.
•  The payment rate for each of the 18 diagnostic groups was the average allowed amount per day over all the ICD-9-CM codes in a diagnosis group, based upon the claim’s primary diagnosis, plus an add-on to reimburse for capital costs.
4.4.3.2  For services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation:
•  A rate setting methodology utilizing the first alpha character and two digits of a primary diagnosis code.
•  Eighteen diagnosis groupings were defined and designed based on the groupings and definitions contained in the ICD-10-CM publication. For example, Group 1 is defined as ICD-10-CM codes A00 to B99, or Infectious and Parasitic Diseases. The first alpha character and two digits of a primary diagnosis code are utilized for placement into one of the 18 groups.
•  The payment rate for each of the 18 diagnostic groups was the average allowed amount per day over all the ICD-10-CM codes in a diagnosis group, based upon the claim’s primary diagnosis, plus an add-on to reimburse for capital costs.
4.4.3.3  Group payments were calculated by dividing total allowed charges by total inpatient days for the group.
4.4.3.4  Once the 18 groupings were defined, certain unique admissions were identified for reimbursement separately from the 18 groupings. These are listed in Figure 1.34-3.
4.5  Payments
4.5.1  General. For services provided before the mandated date, as directed by HHS, for ICD-10 implementation, the per diem group payment rate will be based on the first three digits of the primary diagnosis code. For services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation, the per diem group payment rate will be based on the first alpha character and two digits of the primary diagnosis code. The maximum amount allowed by TRICARE and the amount reimbursed for hospital inpatient care shall be the lesser of:
•  Actual billed charges for hospital inpatient care; or
•  The U.S. National per diem rate authorized under TRICARE, multiplied by the country specific index factor, is the country specific hospital per diem. This per diem is multiplied by the number of covered days of hospital inpatient care and equals the maximum amount allowed by TRICARE to be paid for the episode on inpatient care.
4.5.2  Only the primary diagnosis code, on the date of admission, will be taken into consideration when determining the group for a payment rate. Only one payment group can be assigned to each independent episode of inpatient care. For services provided before the mandated date, as directed by HHS, for ICD-10 implementation, each institutional claim for service reimbursement must contain a valid ICD-9-CM code or narrative description of services, and must be used to represent the primary diagnosis for inpatient admission. For services provided on or after the mandated date, as directed by HHS, for ICD-10 implementation, each institutional claim for service reimbursement must contain a valid ICD-10-CM code or narrative description of services, and must be used to represent the primary diagnosis for inpatient admission. If a valid diagnosis code or narrative description is not supplied by the institutional provider it must be developed and supported by the overseas claims processor. Development of an institutional claim should contain the necessary elements to satisfy TRICARE Encounter Data (TED) requirements.
4.6  Beneficiary - Change in Eligibility Status
Since payment is on a per diem basis, the hospital claim for services shall be paid for the days the beneficiary is TRICARE eligible and denied for the days the beneficiary is not TRICARE eligible.
4.7  Beneficiary Cost-Shares
Inpatient cost-shares as contained in Chapter 2, Section 1, for non-Diagnosis Related Group (DRG) facilities shall be applicable to the hospital allowable charge authorized under TRICARE.
4.8  Updating Payment Rates
4.8.1  Additions, changes, revisions, or deletions to the diagnosis codes or country specific index shall be communicated to the overseas claims processor and be considered as routine updates to this payment system and processed under TRICARE Operations Manual (TOM), Chapter 1, Section 4, paragraph 2.4.
4.8.2  Inpatient per diem rates for Panama and the Philippines will be updated annually in conjunction with the TRICARE DRG update in the U.S.
4.9  The overseas claims processor shall maintain the current year and two immediate past years’ iterations of the U.S. National per diems authorized under TRICARE and the country specific index factors.
4.10  There is no TRICARE waiver process applicable to hospitals in specified locations outside the 50 U.S. and the District of Columbia for institutional inpatient rates.
Figure 1.34-1  Country Specific Index Factors
Country Specific Index Factor
Effective
2008
Philippines
0.52
November 1, 2008
Panama
0.70
February 1, 2009
2012
Philippines
0.57
December 1, 2012
Panama
0.70
December 1, 2012
Figure 1.34-2  Institutional Inpatient Diagnostic Groupings For Specified Locations Outside The 50 U.S. And The District Of Columbia - National Inpatient Per Diem Amounts
Group
Description
ICD-9-CM Code Range
(FOR SERVICES BEFORE the mandated date, as directed by HHS, for ICD-10 implementation)
ICD-10-CM CODE RANGE
(FOR SERVICES ON OR AFTER the mandated date, as directed by HHS, for ICD-10 implementation)
National Inpatient Per Diem
Note:  Care delivered must be a benefit of TRICARE under 32 CFR 199.4 and 199.5.
December 1, 2012
01
Infectious Disease
1 - 139
A00 - B99
$2,475
02
Cancer
140 - 239
C00 - D49
$3,220
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$2,389
04
Mental Health
290 - 319
F01 - F99
$978
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,181
06
Circulatory
390 - 459
I00 - I99
$3,407
07
Respiratory
460 - 519
J00 - J99
$1,977
08
Digestive
520 - 579
K00 - K95
$2,309
09
Genitourinary
580-629
N00 - N99
$2,510
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z34, Z37, Z39
$1,525
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$4,691
12
Congenital abnormalities
740 - 759
Q00 - Q99
$4,282
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z00, Z37
$1,094
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,143
15
Injuries
800 - 959
S00 - T34
$3,573
16
Poisoning
960 - 995
T36 - T50
$2,287
17
Complications
996 - 999
T81 - T88
$2,951
18
All other “V” or “Z” based codes
$2,352
October 1, 2015
01
Infectious Disease
1 - 139
A00 - B99
$2,547
02
Cancer
140 - 239
C00 - D49
$3,492
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$2,625
04
Mental Health
290 - 319
F01 - F99
$1,139
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,365
06
Circulatory
390 - 459
I00 - I99
$3, 614
07
Respiratory
460 - 519
J00 - J99
$2, 054
08
Digestive
520 - 579
K00 - K95
$2,361
09
Genitourinary
580 - 629
N00 - N99
$2,427
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z33, Z34, Z36, Z37, Z39
$1,641
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$5,636
12
Congenital abnormalities
740 - 759
Q00 - Q99
$4,492
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z3A, Z38
$1,226
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,128
15
Injuries
800 - 959
S00 - T34
$3,478
16
Poisoning
960 - 995
T36 - T80
$2,158
17
Complications
996 - 999
T81 - T88
$3,383
18
All other codes
$2,759
October 1, 2016
01
Infectious Disease
1 - 139
A00 - B99
$2,596
02
Cancer
140 - 239
C00 - D49
$3,773
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$2,860
04
Mental health
290 - 319
F01 - F99
$1,235
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,594
06
Circulatory
390 - 459
I00 - I99
$3,795
07
Respiratory
460 - 519
J00 - J99
$2,112
08
Digestive
520 - 579
K00 - K95
$2,492
09
Genitourinary
580 - 629
N00 - N99
$2,486
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z33, Z34, Z36, Z37, Z39
$1,709
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$5,879
12
Congenital abnormalities
740 - 759
Q00 - Q99
$5,290
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z3A, Z38
$1,151
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,288
15
Injuries
800 - 959
S00 - T34
$3,602
16
Poisoning
960 - 996
T36 - T80
$2,376
17
Complications
996 - 999
T81 - T88
$3,691
18
All other codes
$3,013
October 1, 2017
01
Infectious Disease
1 - 139
A00 - B99
$2,573
02
Cancer
140 - 239
C00 - D49
$4,002
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$3,476
04
Mental health
290 - 319
F01 - F99
$1,125
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,739
06
Circulatory
390 - 459
I00 - I99
$4,120
07
Respiratory
460 - 519
J00 - J99
$2,185
08
Digestive
520 - 579
K00 - K95
$2,524
09
Genitourinary
580 - 629
N00 - N99
$2,555
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z33, Z34, Z36, Z37, Z39
$1,706
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$6,387
12
Congenital abnormalities
740 - 759
Q00 - Q99
$5,061
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z3A, Z38
$1,287
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,381
15
Injuries
800 - 959
S00 - T34
$3,767
16
Poisoning
960 - 996
T36 - T80
$2,521
17
Complications
996 - 999
T81 - T88
$3,546
18
All other codes
$2,835
October 1, 2018
01
Infectious Disease
1 - 139
A00 - B99
$2,674
02
Cancer
140 - 239
C00 - D49
$4,107
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$3,410
04
Mental health
290 - 319
F01 - F99
$1,078
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,819
06
Circulatory
390 - 459
I00 - I99
$4,185
07
Respiratory
460 - 519
J00 - J99
$2,242
08
Digestive
520 - 579
K00 - K95
$2,615
09
Genitourinary
580 - 629
N00 - N99
$2,692
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z33, Z34, Z36, Z37, Z39
$1,785
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$6,765
12
Congenital abnormalities
740 - 759
Q00 - Q99
$5,117
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z3A, Z38
$1,247
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,449
15
Injuries
800 - 959
S00 - T34
$3,968
16
Poisoning
960 - 996
T36 - T79
$2,340
17
Complications
996 - 999
T80 - T88
$3,818
18
All other codes
$3,026
October 1, 2019
01
Infectious Disease
1 - 139
A00 - B99
$2,821
02
Cancer
140 - 239
C00 - D49
$4,319
03
Endocrine
240 - 289
D50 - D89, E00 - E89
$3,560
04
Mental health
290 - 319
F01 - F99
$1,167
05
Nervous System
320 - 389
G00 - G99, H00 - H95
$2,911
06
Circulatory
390 - 459
I00 - I99
$4,428
07
Respiratory
460 - 519
J00 - J99
$2,356
08
Digestive
520 - 579
K00 - K95
$2,742
09
Genitourinary
580 - 629
N00 - N99
$2,914
10
Pregnancy, birth (mother)
630 - 679, V22 - V24, V27
O00 - O9A, Z33, Z34, Z36, Z37, Z39
$1,833
11
Musculoskeletal and skin
680 - 739
L00 - L99, M00 - M99
$7,521
12
Congenital abnormalities
740 - 759
Q00 - Q99
$5,319
13
Perinatal Fetus and infant
760 - 779, V21, V29 - V39
P00 - P96, Z3A, Z38
$1,317
14
Signs, Symptoms, etc.
780 - 799
R00 - R99
$2,597
15
Injuries
800 - 959
S00 - T34
$4,250
16
Poisoning
960 - 996
T36 - T79
$2,726
17
Complications
996 - 999
T80 - T88
$3,996
18
All other codes
$2,868
Figure 1.34-3  Unique Admissions - National Inpatient Per Diem Amounts
Description
ICD-9-CM Code
(For Services before the mandated date, as directed by HHS, for ICD-10 implementation)
ICD-10-CM Code
(For Services on or after the mandated date, as directed by HHS, for ICD-10 implementation)
National Inpatient Per Diem
Note:  Care delivered must be a benefit of TRICARE under 32 CFR 199.4 and 199.5.
December 1, 2012
Heart Transplant
V42.1
Z94.1
$9,817
Kidney Transplant
V42.0
Z94.0
$4,993
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$5,765
Lung Transplant
V42.6
Z94.2
$7,221
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$4,525
Pancreas Transplant
V42.83
Z94.83
$5,167
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$4,823
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V45.82
Z98.61
$6,076
October 1, 2015
Heart Transplant
V42.1
Z94.1
$9,034
Kidney Transplant
V42.0
Z94.0
$5,102
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$9,203
Lung Transplant
V42.6
Z94.2
$5,137
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$6,670
Pancreas Transplant
V42.83
Z94.83
$5,209
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$5,210
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V4.82
Z98.61
$6,122
October 1, 2016
Heart Transplant
V42.1
Z94.1
$7,328
Kidney Transplant
V42.0
Z94.0
$5,546
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$6.,392
Lung Transplant
V42.6
Z94.2
$5,589
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$4,871
Pancreas Transplant
V42.83
Z94.83
$8,243
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$5,317
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V45.82
Z98.61
$7,750
October 1, 2017
Heart Transplant
V42.1
Z94.1
$14,535
Kidney Transplant
V42.0
Z94.0
$6,909
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$7,017
Lung Transplant
V42.6
Z94.2
$8,208
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$4,525
Pancreas Transplant
V42.83
Z94.83
$8,243
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$5,630
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V45.82
Z98.61
$6,738
October 1, 2018
Heart Transplant
V42.1
Z94.1
$9,228
Kidney Transplant
V42.0
Z94.0
$7,557
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$6,153
Lung Transplant
V42.6
Z94.2
$5,555
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$4,704
Pancreas Transplant
V42.83
Z94.83
$6,923
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$5,568
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V45.82
Z98.61
$6,631
October 1, 2019
Heart Transplant
V42.1
Z94.1
$9,178
Kidney Transplant
V42.0
Z94.0
$7,145
Combined Small Intestine/Liver (SI/L) Transplant
V42.7
Z94.4
$7,774
Lung Transplant
V42.6
Z94.2
$5,437
Simultaneous Pancreas-Kidney (SPK) Transplant
V42.89
Z94.89
$5,657
Pancreas Transplant
V42.83
Z94.83
$6,984
Coronary Artery Bypass Grafts (CABG)
V43.4
Z95.828
$6,077
Coronary Bypass with Percutaneous Transluminal Coronary Angioplasty (PTCA)
V45.82
Z98.61
$8,455
- END -

Utility Navigation Links

DoD Seal

tricare.mil is the offical website of the Defense Health Agency (DHA) a component of the Military Health System

TRICARE is a registered trademark of the Department of Defense (DoD), DHA. All rights reserved.

CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.

If you have a question regarding TRICARE benefits, please go to the TRICARE Contact Us page page.
If you need help with technical/operational issues, please go to the TRICARE Manuals Online Help Resources page.

The appearance of hyperlinks to external websites does not constitute endorsement by the DHA of these websites or the information, products or services contained therein. For other than authorized government activities, the DHA does not exercise any editorial control over the information you may find at other locations. Such links are provided consistent with the stated purpose of this DoD website.

v4.5.7082.22297

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.