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Outpatient Prospective Payment System (OPPS)


TRICARE's OPPS was implemented on May 1, 2009

Note: To minimize download times, some of these documents are being supplied in zip format as well as unzipped. You must have file compression software on your computer in order to take advantage of the zipped format.

Quarterly Updates

Ambulatory Payment Classifications (APCs) with Status Indicators (SIs) and Payment Rates

   

Payment Status by HCPCS Code

   

Payment Status Indicators

   

Annual Updates

Maternity Diagnosis

   

OPPS Pricing Elements

   

Statewide Cost to Charge Ratios

   

Therapy Codes

   

Provider Information Updates

OPPS Provider File

   
       Provider Types contained in the OPPS provider file (click to expand)
       Provider Types (download)

Zip to Wage Index Crosswalk

   

Communication Articles

TRICARE Reimbursement Manual

       Reimbursement Manual (OPPS is contained in Chapter 13) (Link opens in new browser window.)

Applicable FARS/DFARS Restrictions Apply to Government Use
www.tricare.mil is the official Web site of the TRICARE Management Activity, a component of the Military Health System 7700 Arlington Boulevard, Suite 5101, Falls Church, VA 22042-5101

The appearance of hyperlinks to external Web sites does not constitute endorsement by the TRICARE Management Activity of these Web sites or the information, products or services contained therein. For other than authorized government activities, TRICARE Management Activity does not exercise any editorial control over the information you may find at other locations. Such links are provided consistent with the stated purpose of this DoD Web site.