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plan, location, specialty and services performed.

Psychologists who treat active duty troops are paid 66 percent of what Tricare views as the customary rate. So a psychologist eligible for a customary rate of $120 per hour would be paid $79.20 for the hour by Tricare, even if the psychologist's standard rate is $150 per hour.

Active duty troops use Tricare Prime, a managed-care option maintained by private contractors. Their mental health care is free. Guard and Reserve troops and their families frequently use Tricare Standard, a fee-for-service plan. They pay an annual deductible and 20 percent of the amount Tricare pays the therapist.

John Class, a retired Navy health care administrator who now advocates on health issues for the Military Officers Association of America, said Tricare Prime contractors insist that the lower reimbursement rates has made it tougher to maintain a network of providers.

"We are already starting to see the pinch," Class said.

In a limited study by Tricare released earlier this year, about two out of three civilian psychiatrists in 20 states were willing to accept Tricare Standard clients among their new patients, the lowest acceptance rate for any specialty.

Any additional cuts in Tricare payouts could mean that "some really good psychologists who specialize in this treatment and are experienced will be seeing less of (military families)," said clinical psychologist Marion Frank, a widow who is president of the Philadelphia Chapter of the Gold Star Wives of America, a support group for military widows.

In parts of Montana, some families drive two hours to see a physician of any kind that will take Tricare, said Dorrie Hagan, state family program director for the Montana National Guard.

"When you get away from a city of any size then you start struggling for providers, and they'll tell you flat out it's because of the rate
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