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TRICARE Changes: New Payment Rules for Medical Care

This bill modifies how the TRICARE program pays for medical services, introducing lower rates based on where care is provided. The aim is to standardize and potentially reduce healthcare costs for individuals covered by TRICARE, which might affect the availability of certain services.
Key points
TRICARE will pay the lowest possible rate for medical services if multiple options are available.
Payment rates will depend on the location where care was provided (e.g., hospital, outpatient clinic, doctor's office).
All reimbursement claims must include a unique code identifying the exact location where the service was rendered.
These changes will take effect on January 1, 2026.
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Status:
Introduced
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Additional Information
To amend title 10, United States Code, to modify the rate of pay for care or services provided under the TRICARE program based on the location at which such care or services were provided.
Print number: HR 873
Sponsor: Rep. McCormick, Richard [R-GA-7]
Process start date: 2025-01-31