A nonparticipating provider in TRICARE sees a patient and provides two services, one with an allowed charge of $120 and the other for $220. Calculate the maximum amount they may charge the patient.

Question

Quizplus · Accepted Answer

Nonparticipating providers can charge up to 15% over the TRICARE allowable charge. The total allowable charge is $120 + $220 = $340. 15% of $340 is $51. Therefore, the maximum amount they may charge is $340 + $51 = $391.

A Nonparticipating Provider in TRICARE Sees a Patient and Provides