2022 CHAMPUS Maximum Allowable Charge Rate Changes

Wednesday, April 13, 2022

The CHAMPUS Maximum Allowable Charge (CMAC), which aligns with Medicare reimbursement rates and rules for similar services (refer to 42 U.S.C., Section 1395 for more information), is the maximum amount TRICARE will reimburse for nationally established procedure codes. 

Periodic CMAC changes apply to both network and non-network providers and are subject to change per United States Department of Defense guidelines. At the end of 2021, a COVID-19–related temporary 3.75% payment boost, which was approved for calendar year 2021, expired, and the expiration of the temporary payment boost has affected 2022 Medicare and CMAC rates for some services, including mental health care services. 

You can review updated CMAC rates, based on site of service, at www.health.mil/rates.