A:
We have established a national rate for all categories of ABA care which is consistent with every other medical need TRICARE covers. In addition, TRICARE implements a universally established procedure to adjusting the national rate to reflect the capacity of the provider network and the cost of living in 88 localities across the country using the Medicare Geographic Practice Cost Index (GPCI). The reimbursement rates of virtually all TRICARE covered benefits apply this method. Having the GPCI applied to ABA is a step towards transitioning ABA from an educational resource to a medical service which is stated as an objective of this demonstration project. Locality rates have also now been calculated and released on December 1, 2015.
This process ensures the ABA rates will be adjusted annually based on the established or newly created statewide Medicaid rates and published at the same time as the CHAMPUS Maximum Allowable Charge rates, which is normally in March or April of each year.