Things to Consider
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. If you want to know what TRICARE will pay a provider in a specific area, visit the Allowable Charges Search Tool.
Please understand that the amounts provided by the search tool do not reflect a patient’s out of pocket cost shares, co-payments, deductibles, or payments made by any other health care coverages.
Claims Processing
TRICARE is an industry leader in claims processing timeliness. The TRICARE program provides fast and consistent adjudication with over 99 percent of claims paid within 30 days, and all within 60 days. Each managed care support contractor has subcontracted with a claims processor to expedite claims in each region.