What TRICARE Pays to Providers

The maximum amount that TRICARE can pay a provider for a procedure or service is known as the TRICARE allowable charge. The TRICARE allowable charge is tied by law to Medicare's allowable charge whenever practical and may vary based on the prevailing rate in a given location.

Rates and Reimbursement

The TRICARE Reimbursement Manual provides the methodology for pricing allowable services and items and for payment to specific categories and types of authorized providers. Please view the tools listed below to view rates TRICARE will pay to providers. The amounts do not reflect a patient’s out of pocket cost shares, co-payments, deductibles, or payments made by any other health care coverages. Visit the Health Plan Costs page to view beneficiary out-of-pocket costs.

Last Updated 9/17/2013