May
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Program Manager Continues Serving Military Members, Families, After Almost 40 Years
Retired U.S. Navy Corpsman continues to serve military members and their families throughout the Military Health System.
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This page serves as a central repository for rates within the TRICARE/CHAMPUS DRG-Based Payment System. Use the dropdowns below to view current and historical data related to DRG-Based Payments.
Based on the Final Rule [84 FR 4333] that published on February 15, 2019, the TRICARE DRG effective date will be delayed to January 1, for FY20 and beyond. See 32 CFR 199.14, (a)(1)(i)(D) DRG system updates. The CHAMPUS DRG-based payment system is modeled on the Medicare Prospective Payment System (PPS) and uses annually updated items and numbers from the Medicare PPS as provided for in this part and in instructions issued by the Director, DHA. The effective date of these items and numbers shall not correspond to that under Medicare PPS but shall be delayed until January 1, to align with TRICARE's program year reporting. This allows for an administrative simplicity that optimizes healthcare delivery by reducing existing administrative burden and costs.
TRICARE has adopted the same Hospital-Acquired Conditions as CMS.
The appearance of hyperlinks does not constitute endorsement by the Department of Defense of non-U.S. Government sites or the information, products, or services contained therein. Although the Defense Health Agency may or may not use these sites as additional distribution channels for Department of Defense information, it does not exercise editorial control over all of the information that you may find at these locations. Such links are provided consistent with the stated purpose of this website.