OFFICE OFTHE ASSISTANT SECRETARY OF DEFENSE HEALTH AFFAIRS 16401 EAST CENTRETECH PARKWAY AURORA. COLORADO 80011-9066 TRICARE MANAGEMENT ACTIVITY MB&RB CHANGE 69 6010.S8-M MAY 23, 2012 PUBLICATIONS SYSTEM CHANGE TRANSMITTAL FOR TRICARE REIMBURSEMENT MANUAL (TRM), FEBRUARY 2008 The TRICARE Management Activity has authorized the following addition(s)/revision(s). CHANGE TITLE: APRIL 2012 REIMBURSEMENT AND CODING UPDATES CONREQ: 15971 PAGE CHANGE(S): See page 2. SUMMARY OF CHANGE(S): See page 3. EFFECTIVE DATE: As indicated, otherwise upon direction of the Contracting Officer. IMPLEMENTATION DATE: Upon direction of the Contracting Officer. This change is made in conjunction with Feb 2008 TPM, Change No. 67. Ann N. Fazzini Chief, Medical Benefits and Reimbursement Branch ATTACHMENT(S): DISTRIBUTION: 4 PAGE(S) 6010.S8-M WHEN PRESCRIBED ACTION HAS BEEN TAKEN, FILE THIS TRANSMITIAL WITH BASIC DOCUMENT.
CHANGE 69 6010.58-M MAY 23, 2012 REMOVE PAGE(S) INSERT PAGE(S) CHAPTER 10 Table of Contents, page 1 Table of Contents, page 1 Addendum A, pages 1-3 Addendum A, pages 1-3 2
CHANGE 69 6010.58-M MAY 23, 2012 SUMMARY OF CHANGES CHAPTER 20 1. Table of Contents. Deleted Figure 10.A-1 2009 Rate Year, renumber subsequent Figures. Added Figure 10.A-3 2012 Rate Year. 2. Addendum A. Updates the TRICARE Birthing Center Reimbursement System for 2012 Rate Year. 3
TRICARE Reimbursement Manual 6010.58-M, February 1, 2008 Chapter 10 Birthing Centers Section/Addendum Subject/Addendum Title 1 Freestanding And Hospital-Based Birthing Center Reimbursement A Birthing Center Rate Non-Professional Component Figure 10.A-1 2010 Rate Year Figure 10.A-2 2011 Rate Year Figure 10.A-3 2012 Rate Year 1 C-69, May 23, 2012
Chapter 10 TRICARE Reimbursement Manual 6010.58-M, February 1, 2008 Birthing Centers Addendum A Birthing Center Rate Non-Professional Component FIGURE 10.A-1 2010 RATE YEAR These state specific non-professional component amounts are to be used in creating the maximum allowable all-inclusive TRICARE-authorized birthing center prices during the 2010 rate year (i.e., April 1, 2010 - March 31, 2011). The all-inclusive prices are to be updated on April 1st each year to coincide with the Outpatient Prospective Payment System (OPPS) quarterly update. (See Section 1, for instruction for the use of these amounts.) 2010 RATE YEAR TRICARE-AUTHORIZED BIRTHING CENTER PROVIDER NON-PROFESSIONAL COMPONENT FOR ALL-INCLUSIVE PRICING FORMULA Alabama $3,687.08 Montana $1,943.18 Alaska $4,723.28 Nebraska $2,577.81 Arizona $2,648.44 Nevada $4,192.52 Arkansas $4,574.03 New Hampshire $2,859.78 California $4,228.43 New Jersey $5,514.34 Colorado $3,458.81 New Mexico $2,742.22 Connecticut $4,730.81 New York $1,688.40 Delaware $3,421.02 North Carolina $3,291.56 District of Columbia $4,497.00 North Dakota $1,941.12 Florida $3,896.83 Ohio $3,439.20 Georgia $3,255.65 Oklahoma $3,504.88 Hawaii $2,762.12 Oregon $2,401.87 Idaho $2,452.04 Pennsylvania $3,495.45 Illinois $2,785.58 Puerto Rico $658.06 Indiana $3,522.74 Rhode Island $4,832.65 Iowa $2,572.99 South Carolina $3,882.03 Kansas $3,695.42 South Dakota $1,928.55 Kentucky $2,526.19 Tennessee $2,792.61 Louisiana $2,773.83 Texas $3,257.16 Maine $2,395.12 Utah $1,708.36 Maryland $2,508.70 Vermont $2,613.08 Massachusetts $3,017.37 Virginia $2,274.32 Michigan $3,064.31 Washington $3,298.17 Minnesota $3,351.13 West Virginia $2,147.32 Mississippi $3,704.91 Wisconsin $2,287.41 Missouri $2,676.94 Wyoming $3,652.84 1 C-69, May 23, 2012
TRICARE Reimbursement Manual 6010.58-M, February 1, 2008 Chapter 10, Addendum A Birthing Center Rate Non-Professional Component FIGURE 10.A-2 2011 RATE YEAR These state specific non-professional component amounts are to be used in creating the maximum allowable all-inclusive TRICARE-authorized birthing center prices during the 2011 rate year (i.e., April 1, 2011 - March 31, 2012). The all-inclusive prices are to be updated on April 1st each year to coincide with the Outpatient Prospective Payment System (OPPS) quarterly update. (See Section 1, for instruction for the use of these amounts.) 2011 RATE YEAR TRICARE-AUTHORIZED BIRTHING CENTER PROVIDER NON-PROFESSIONAL COMPONENT FOR ALL-INCLUSIVE PRICING FORMULA Alabama $3,656.83 Montana $2,231.60 Alaska $4,553.19 Nebraska $2,475.72 Arizona $2,793.52 Nevada $4,665.20 Arkansas $5,117.36 New Hampshire $2,847.81 California $4,609.80 New Jersey $5,827.68 Colorado $3,732.39 New Mexico $2,614.97 Connecticut $4,841.99 New York $1,734.83 Delaware $3,569.58 North Carolina $3,261.50 District of Columbia $6,269.80 North Dakota $1,824.34 Florida $4,113.47 Ohio $3,692.88 Georgia $3,321.75 Oklahoma $3,794.17 Hawaii $3,156.78 Oregon $2,418.29 Idaho $2,725.22 Pennsylvania $3,881.02 Illinois $2,838.53 Puerto Rico $749.53 Indiana $3,513.73 Rhode Island $5,530.25 Iowa $2,782.61 South Carolina $4,197.53 Kansas $3,703.21 South Dakota $1,996.86 Kentucky $2,270.34 Tennessee $2,810.29 Louisiana $2,838.60 Texas $3,351.01 Maine $2,494.95 Utah $1,750.27 Maryland $2,667.73 Vermont $2,798.90 Massachusetts $3,069.20 Virginia $2,710.71 Michigan $3,125.05 Washington $3,467.55 Minnesota $3,312.19 West Virginia $2,234.06 Mississippi $3,667.96 Wisconsin $2,670.72 Missouri $2,821.78 Wyoming $3,788.18 2 C-69, May 23, 2012
TRICARE Reimbursement Manual 6010.58-M, February 1, 2008 Chapter 10, Addendum A Birthing Center Rate Non-Professional Component FIGURE 10.A-3 2012 RATE YEAR These state specific non-professional component amounts are to be used in creating the maximum allowable all-inclusive TRICARE-authorized birthing center prices during the 2012 rate year (i.e., April 1, 2012 - March 31, 2013). The all-inclusive prices are to be updated on April 1st each year to coincide with the Outpatient Prospective Payment System (OPPS) quarterly update. (See Section 1, for instruction for the use of these amounts.) 2012 RATE YEAR TRICARE-AUTHORIZED BIRTHING CENTER PROVIDER NON-PROFESSIONAL COMPONENT FOR ALL-INCLUSIVE PRICING FORMULA Alabama $3,793.03 Montana $2,438.92 Alaska $5,373.44 Nebraska $1,942.30 Arizona $2,759.20 Nevada $4,899.27 Arkansas $5,999.83 New Hampshire $3,391.12 California $4,844.87 New Jersey $6,038.37 Colorado $3,952.66 New Mexico $2,771.74 Connecticut $5,199.31 New York $1,850.60 Delaware $3,849.00 North Carolina $3,447.08 District of Columbia $4,451.71 North Dakota $1,900.30 Florida $4,266.16 Ohio $4,186.51 Georgia $3,424.74 Oklahoma $4,058.54 Hawaii $3,148.67 Oregon $2,599.17 Idaho $2,889.61 Pennsylvania $4,146.75 Illinois $3,282.25 Puerto Rico $789.58 Indiana $3,607.10 Rhode Island $5,274.93 Iowa $2,941.05 South Carolina $4,156.78 Kansas $3,961.45 South Dakota $2,051.96 Kentucky $2,413.63 Tennessee $2,842.80 Louisiana $3,026.70 Texas $3,533.35 Maine $2,644.77 Utah $1,932.24 Maryland $2,882.59 Vermont $2,898.65 Massachusetts $3,457.25 Virginia $2,923.98 Michigan $3,246.90 Washington $3,625.24 Minnesota $3,606.34 West Virginia $2,293.41 Mississippi $3,967.05 Wisconsin $2,510.62 Missouri $3,057.98 Wyoming $4,024.52 - END - 3 C-69, May 23, 2012