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TRICARE Reimbursement Manual 6010.61-M, April 2015, Change 66 (Jan 6, 2023)
Published Change
Reimbursement & Coding Change 22-001
Published Date: January 6, 2023
CONREQ:22063
Implementation Date:February 6, 2023
This change is made in conjunction with TRICARE Policy Manual 6010.60-M, April 2015, Change 107.
Summary of Changes:
CHAPTER 1
  1. Section/Addendum 14. This change provides technical corrections. EFFECTIVE DATE: January 6, 2023
CHAPTER 1
  1. Section/Addendum 29. This change provides technical corrections. EFFECTIVE DATE: February 6, 2023
CHAPTER 1
  1. Section/Addendum 34. Figures 1.34-2 and 1.34-3. This change provides technical corrections and updates the DRG rates for Panama and the Philippines. EFFECTIVE DATE: October 1, 2022
CHAPTER 1
  1. Section/Addendum 35. This change provides technical corrections. EFFECTIVE DATE: January 6, 2023
CHAPTER 1
  1. Section/Addendum 37. This change provides technical corrections. EFFECTIVE DATE: January 6, 2023
CHAPTER 1
  1. Section/Addendum 41. Figure 1.41-1. This change adds a technical correction. EFFECTIVE DATE: January 1, 2020
CHAPTER 2
  1. Section/Addendum 1. Figure 2.1-1. This change provides the updated mental health reimbursement rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 2
  1. Section/Addendum 2. Figures 2.2-2, 2.2-3, 2.2-23, & 2.2-27. This change adds a technical correction. EFFECTIVE DATE: February 6, 2023
CHAPTER 2
  1. Section/Addendum 5. This change corrects cross-reference. EFFECTIVE DATE: February 6, 2023
CHAPTER 2
  1. Section/Addendum A. This change adds a technical correction. EFFECTIVE DATE: February 6, 2023
CHAPTER 3
  1. Section/Addendum 1. This change corrects cross-reference. EFFECTIVE DATE: February 6, 2023
CHAPTER 4
  1. Section/Addendum 1. This change corrects cross-reference. EFFECTIVE DATE: February 6, 2023
CHAPTER 5
  1. Section/Addendum 1. This change corrects cross-reference. EFFECTIVE DATE: February 6, 2023
CHAPTER 5
  1. Section/Addendum 3. This change corrects cross-reference. EFFECTIVE DATE: February 6, 2023
CHAPTER 6
  1. Section/Addendum 7. This change adds calendar year 2022 updates to the following: Daily Hospital Charges for ADFM, DRG Inpatient Cost-share, Cost-to-Charge Ratio for ASA, Cost-to-Charge Ratio for admissions, The National Operating Std Cost Share of Total Costs, TRICARE fixed loss cost-outlier, Children's Cost-to-Charge Ratio, Children's Marginal Cost Factor updates. EFFECTIVE DATE: January 1, 2022
CHAPTER 6
  1. Section/Addendum 8. This change adds calendar year 2022 updates to the following: Daily Hospital Charges for ADFM, DRG Inpatient Cost-share, Cost-to-Charge Ratio for ASA, Cost-to-Charge Ratio for admissions, The National Operating Std Cost Share of Total Costs, TRICARE fixed loss cost-outlier, Children's Cost-to-Charge Ratio, Children's Marginal Cost Factor updates. EFFECTIVE DATE: January 1, 2022
CHAPTER 6
  1. Section/Addendum 10. This change provides technical corrections. EFFECTIVE DATE: February 6, 2023
CHAPTER 6
  1. Section/Addendum 11. This change gives guidance for situations when Medicare expires and NTAP and creates an MS-DRG. EFFECTIVE DATE: January 1, 2020
CHAPTER 7
  1. Section/Addendum A. This change provides the updated mental health reimbursement rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 7
  1. Section/Addendum B. This change provides the updated mental health reimbursement rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 8
  1. Section/Addendum 1. This change provides technical corrections. EFFECTIVE DATE: February 6, 2023
CHAPTER 9
  1. Section/Addendum 1. This change adds an update to reflect the updated factor ASC payments. EFFECTIVE DATE: January 1, 2022
CHAPTER 11
  1. Section/Addendum 4. This change provides the updated national hospice rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 11
  1. Section/Addendum A. (2019). This change deletes this addendum. EFFECTIVE DATE: January 6, 2023
CHAPTER 11
  1. Section/Addendum A. (2022). This change provides the updated national hospice rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 11
  1. Section/Addendum B. (2019). This change deletes this addendum. EFFECTIVE DATE: January 6, 2023
CHAPTER 11
  1. Section/Addendum B. (2022). This change provides the updated national hospice rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 11
  1. Section/Addendum C. (2019). This change deletes this addendum. EFFECTIVE DATE: January 6, 2023
CHAPTER 11
  1. Section/Addendum C. (2022). This change provides the updated national hospice rates, cap amount and wage indexes for care and services provided on or after October 1, 2021 through September 30, 2022. EFFECTIVE DATE: October 1, 2021
CHAPTER 12
  1. Section/Addendum 6. This change provides technical corrections. EFFECTIVE DATE: February 6, 2023
CHAPTER 12
  1. Section/Addendum 9. This change updates the HHA PPS rates for CY 2022, adds a LUPA add-on for Occupational Therapy, and removes the requirement for providers to submit Request for Anticipated Payments (RAPs) under TRM, Chapter 9, Section 12. EFFECTIVE DATE: January 1, 2022
CHAPTER 12
  1. Section/Addendum C. (2019). This change deletes this addendum. EFFECTIVE DATE: January 6, 2023
CHAPTER 12
  1. Section/Addendum C. (2022). This change updates the HHA PPS rates for CY 2022, adds a LUPA add-on for Occupational Therapy, and removes the requirement for providers to submit Request for Anticipated Payments (RAPs) under TRM, Chapter 9, Section 12. EFFECTIVE DATE: January 1, 2022
Affected Sections:
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