Hospitals subject to the TRICARE DRG-based payment system who wish to be reimbursed for Allowed Capital and Direct Medical Education costs (as outlined in the TRICARE Reimbursement Manual) must submit a request for reimbursement to the appropriate TRICARE/CHAMPUS authorized contractors of Managed Care Support Contracts.
The latest form for Diagnosis Related Groups (DRG) Reimbursement (Two Parts) expires 2022-03-31 and can be found here.
Document Name |
---|
Supporting Statement A |
Approved without change |
Revision of a currently approved collection | 2022-03-29 | |
Approved without change |
Revision of a currently approved collection | 2019-01-18 | |
Approved without change |
Reinstatement with change of a previously approved collection | 2015-10-27 | |
Approved without change |
Reinstatement without change of a previously approved collection | 2012-07-05 | |
Approved without change |
Extension without change of a currently approved collection | 2007-08-31 | |
Approved with change |
Reinstatement without change of a previously approved collection | 2004-01-29 | |
Approved without change |
Existing collection in use without an OMB Control Number | 1997-11-10 |