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
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.
- 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.