To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided.
This bill proposes to amend title 10, United States Code, to significantly alter how healthcare providers are reimbursed under the TRICARE program . Its primary goal is to ensure that payment rates for care or services are directly tied to the specific physical location where those services are rendered, rather than a general rate. Specifically, the legislation mandates that if the Secretary has the option to choose among multiple reimbursement rates for a service, the lowest authorized rate must be paid . It further requires the Secretary to establish distinct reimbursement rates for services provided at various locations, such as inpatient hospitals, outpatient departments, ambulatory surgical centers, and physician offices. To facilitate this, claims for reimbursement will need to include a unique, geographically specific national provider identifier code , with these changes taking effect on January 1, 2026.
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Timeline
Introduced in House
Referred to the House Committee on Armed Services.
Introduced in House
Referred to the House Committee on Armed Services.
Armed Forces and National Security
Health care costs and insuranceMilitary medicine
To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided.
USA119th CongressHR-873| House
| Updated: 1/31/2025
This bill proposes to amend title 10, United States Code, to significantly alter how healthcare providers are reimbursed under the TRICARE program . Its primary goal is to ensure that payment rates for care or services are directly tied to the specific physical location where those services are rendered, rather than a general rate. Specifically, the legislation mandates that if the Secretary has the option to choose among multiple reimbursement rates for a service, the lowest authorized rate must be paid . It further requires the Secretary to establish distinct reimbursement rates for services provided at various locations, such as inpatient hospitals, outpatient departments, ambulatory surgical centers, and physician offices. To facilitate this, claims for reimbursement will need to include a unique, geographically specific national provider identifier code , with these changes taking effect on January 1, 2026.