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TRICARE West for Providers

News and Updates

  1. We are holding new home health agency claims as we await TRICARE's Home Health Value-Based Purchasing Demonstration and Patient-Driven Groupings Model pricing.  

  2. As of Jan. 1, 2020, TRICARE covers annual 3-D mammography screenings through its provisional coverage program. Previously, TRICARE only covered 3-D mammograms for diagnostic purposes. Because this is a provisional benefit, prior authorization is required regardless of TRICARE plan type. 

  3. View the 2020 TRICARE West Region Provider Handbook and quick reference chartsThese materials are updated annually and contain important information about the TRICARE program.  

  4. TRICARE now posts updated diagnosis-related group reimbursement (DRG) rates for inpatient facility charges on a calendar year (Jan. 1–Dec. 31) rather than a fiscal year (Sept. 1–Oct. 30) basis. Providers may experience a delay in facility claims processing while rates are being updated. 

  5. Want more news? Review past articles in our news archive