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Professional News
Published Online: 7 December 2017

What Can You Charge TRICARE Patients?

Ellen JaffeAuthors Info & Affiliations
Publication: Psychiatrics News
Volume 52, Number 24
https://doi.org/10.1176/appi.pn.2017.12b12
Q. I have a new patient who receives her care through TRICARE, the health benefit program that serves members of the uniformed services and their families. I have opted out of Medicare and do not have any relationship with TRICARE. I would like to have a private contract with her and charge her my standard fee, but she has informed me that I am permitted to charge her only up to the Medicare limiting fee. Is this correct?
A. Yes, this is correct. If you see a patient covered by TRICARE, regardless of whether you have a relationship with TRICARE or your Medicare provider status, the only way you would be permitted to charge more than the Medicare limiting fee (which can be found in the online Medicare physician fee schedule for your location) is if the patient requested a waiver so that a higher fee could be levied by the physician.
If you have questions about reimbursement, coding, documentation, and related practice issues contact the Practice Management HelpLine at [email protected] or (800) 343-4671.

Biographies

Ellen Jaffe is the manager of APA’s Practice Management HelpLine.

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Go to Psychiatric News
Psychiatrics News
Volume 52 • Number 24 • December 2, 2017 – December 15, 2017

History

Published online: 7 December 2017
Published in print: December 2, 2017 – December 15, 2017

Keywords

  1. TRICARE
  2. Military medical care
  3. Limiting fee
  4. Medicare physician fee schedule

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