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Included are costs associated with the delivery of the TRICARE benefit which provides for the health care of eligible active duty family members, retired members and their family members, and the eligible surviving family members of deceased active duty and retired members. [1]
The Tricare logo. Tricare (styled TRICARE) is a health care program of the United States Department of Defense Military Health System. [1] Tricare provides civilian health benefits for U.S Armed Forces military personnel, military retirees, and their dependents, including some members of the Reserve Component.
The Healthcare Common Procedure Coding System (HCPCS, often pronounced by its acronym as "hick picks") is a set of health care procedure codes based on the American Medical Association's Current Procedural Terminology (CPT). [1]
In October 2001, TRICARE benefits were extended to retirees and their dependents aged 65 and over. [1] On Oct. 1, 2013, the Defense Health Agency replaced the TRICARE Management Activity. The MHS has a $50+ billion budget and serves approximately 9.5 million beneficiaries. [4]
For example, in 2005, a generic 99213 Current Procedural Terminology (CPT) code was worth 1.39 Relative Value Units, or RVUs. Adjusted for North Jersey, it was worth 1.57 RVUs. Using the 2005 Conversion Factor of $37.90, Medicare paid 1.57 * $37.90 for each 99213 performed, or $59.50.
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The ICD-10 Procedure Coding System (ICD-10-PCS) is a US system of medical classification used for procedural coding.The Centers for Medicare and Medicaid Services, the agency responsible for maintaining the inpatient procedure code set in the U.S., contracted with 3M Health Information Systems in 1995 to design and then develop a procedure classification system to replace Volume 3 of ICD-9-CM.
In the United States, the average wholesale price (AWP) is a prescription drug term referring to the average price for medications offered at the wholesale level. [1] The metric was originally intended to convey real pricing information to third-party payers, including government prescription drug programs.