Use the ChampVA Non-OPPS tab in the TRICARE node to define reimbursement terms for Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) outpatient surgeries for service prior to August 12, 2022, for Acute and Children’s Hospital. For services on or after August 12, 2022, use the TRICARE OPPS term.
ChampVA Cancer Hospital continues to use the ChampVA Non-OPPS tab through dates of service prior to March 1, 2024. For services on or after March 1, 2024, use the TRICARE OPPS term.
Field Descriptions
The following table describes the fields on the ChampVA Non-OPPS tab of the TRICARE node.
|
Field |
Description |
|
Hospital Outpatient Department |
Defines the pricing logic for outpatient procedures performed in hospital outpatient departments. |
|
Override Rev 45X ER Visit Codes |
Provides the option to override the percentage for revenue codes beginning with "45" for ER CPT 99281-99285 and 99281-99292. |
|
Override Rev 637 |
Provides the option to override Self Administered Drug (Rev Code 0637) with a specific percentage of billed charges. |
|
Override Clinical Labs |
Provides the option to override Clinical Labs (Rev Codes 0300 - 0309) with a specific percentage of CMAC Fee Schedule rate. |
|
Global |
|
|
Truncate (do not round) total |
Provides the option to truncate the total. For example if a total is 100.85, it is truncated to 100. If left unchecked, the total will round to 101. |
|
Do not consume units |
Provides the option not to consume units. This is used for contract carve outs. |
|
Do not consume charges |
Provides the option not to consume charges. This is used for contract carve outs. |