Each year, once Medicare establishes its pricing, the TRICARE CHAMPUS maximum allowable charge (CMAC)
is also updated.
The CMAC is the maximum amount TRICARE covers for professional services (e.g., physicians, nurse practitioners,
physician assistants, anesthesiologists). CMAC pricing varies by location, with 90 locality codes covering the United
States based on ZIP codes.
To check the CMAC rates in your area, go to TRICARE Web site. Accept the end-user agreement and then click on
“CMAC Procedure Pricing.” Procedure pricing is based on your locality code.
You can select your locality code from the menu based on your geographic region, or you can look up the code by
selecting a state, entering a military treatment facility catchment area code or entering a ZIP code.
For more information call 1-800-444-5445.