Use the TRICARE Non-OPPS Calculator

Use this procedure for the TRICARE Non-OPPS Calculator.

Note: The Service From date must be on or after 10/01/2002.

  1. To access the TRICARE Non-OPPS Calculator page, select Go To > Government Payor Research > TRICARE > Non-OPPS Outpatient Calculator.

    Note: If your facility shares its database with other facilities, a Facility drop-down list appears that lets the you select the correct facility.

  2. Specify the calculation criteria and optional values. For more information about each calculation criteria, refer to the Field Descriptions table below.
  3. To add or remove lines for line item entry:
    • Click +1, +5, or +10 to add one, five or ten additional lines. The maximum number of Line Item Entries is 200.
    • Click - to delete a line.
  4. Click Calculate. The results appear. For more information, refer to View the TRICARE Non-OPPS Calculator Results.

    Note: This screen refreshes every 15 minutes. If you are adding Line Item Entries when the window refreshes, all entered information will be saved, however, all blank lines (except the original five) will be deleted.

The following table describes each of the fields on the TRICARE Non-OPPS Calculator page.

Field

Description

Bill Type

Bill type; defaults to 131, however does not confirm that this is the correct bill type.

CPT/HCPC Codes

Associated CPT or HCPC codes

Date of Birth

Patient birth date

Discharge Status

Patient’s destination upon discharge (home, LTC, and so on)

Patient Gender

Patient gender

Revenue Code

Revenue code; at least one revenue code per line item is required. Revenue code is auto filled to three digits, for example, if you type “2” the system fills “002”

Service Date

Date the service was rendered

Service From

First date of service rendered to the patient. This is required information.

Service Through

Ending date the service was performed; required information. Cannot be prior to Service From date.

Total Charges

Total charges for the procedure/line item

Units

Number of units; required information; defaults to 1.