State Prevailing Fees Updated

TriWest Healthcare Alliance recently updated the reimbursement schedule for codes that do not have an established CHAMPUS Maximum Allowable Charge (CMAC) reimbursement rate, effective May 1, 2009.

CMAC rates are established by the TRICARE Management Activity (TMA) for various codes and are used by TriWest where established. However, not all codes have established CMAC rates. For codes that do not have a CMAC rate, TriWest developed reimbursement amounts based on Medicare rates, state prevailing rates or other proprietary methodologies. These codes can be found in the Reimbursement Rates section on www.triwest.com/provider.

Published Date: 07/23/2009