Tricare

New TRICARE Coverage

TRICARE Coverage of Certain Medical Benefits in Response to the COVID-19 Pandemic- Interim Final Rule, Department of Defense, RIN 0720-AB82, Federal Register 9/3/2020.

Major drug-related provisions:
TRICARE will provide temporary coverage of investigational drugs used in the treatment of COVID-19 provided under expanded access INDs and protocols as authorized by the FDA but will not include the use of investigational drugs in clinical trials. This is retroactive to January 27, 2020 and will continue through the term of the HHS Secretary’s Public Health Emergency (PHE). It includes both costs associated with administration of the investigational drug, as well as the cost of the drug.

TRICARE permanently adopts (1) Medicare’s NTAP payment adjustment to DRGs, for new technologies approved by Medicare, and (2) Medicare’s HVBP Program. These changes are retroactive to January 1, 2020 and will not expire.

TRICARE Payment Status by HCPCS Code for Drugs: 2020 3rd Quarter

TRICARE Payment Status Indicators for Hospitals: 2020 3rd Quarter

Billing Tips for Immunizations

TRICARE OPPS Fact Sheet

TRICARE INPATIENT REIMBURSEMENT FOR BLOOD CLOTTING FACTORS FOR HEMOPHILIA (page 3)