TRICARE Systems Manual 7950.2-M


The TRICARE System Manual (TSM), 7950.2-M, defines the contractor's responsibilities for automated processing of health care information, reporting and transmission of relevant data between the contractor and the TRICARE Management Activity (TMA). The manual also provides the requirements for the TRICARE contractors to interface with the Defense Enrollment Eligibility Reporting System (DEERS) for obtaining beneficiary eligibility verifications from DEERS and performing TRICARE Prime enrollments onto DEERS.
NOTE
The MCS Manuals for contracts prior to 06/26/2008 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual. For the ADP Manual, select the TSM Manual.

February 1, 2008 edition

This manual is valid for contracts awarded on or after June 27, 2008 for the North, South, and West Regions along with TQMC, CARS, TOP, and TPharm. The manuals will apply to the TDEFIC contract upon direction of the Contracting Officer.
The February 1, 2008 edition of the TRICARE Systems Manual (TSM), 7950.2-M, is available online.
All future changes will be published to this edition.
Last Updated: June 29, 2017
Most Recent Change Number: Change 95

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Page Count: 954
Summary of Changes: See the Change Transmittal. This change is published in conjunction with Feb 2008 TRM Change 141.


August 1, 2002 edition - Superseded

This manual is valid for contracts awarded on or after May 1, 2003 through June 26, 2008 for the North, South, and West Regions along with TDEFIC, NQMC, CARS, Retail, and TMOP.
The August 1, 2002 edition of the TRICARE System Manual (TSM), 7950.1-M, is available on online. This edition reissued the February 18, 2000 edition. Also, the August 1, 2002 edition of the TSM replaces the May 1, 1999 edition of the ADP Manual. All changes to the May 1, 1999 edition of the ADP Manual (through Change 51 dated October 22, 2004) have been incorporated.
No future changes will be published to this edition.
Last Updated: April 3, 2013
Most Recent Change Number: Change 102

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Page Count: 1,114
Summary of Changes: See the Change Transmittal. This change is published in conjunction with Aug 2002 TPM Change 175 and Aug 2002 TRM Change 159.


May 27, 1999 edition - Superseded

This manual is valid for contracts awarded on or before April 30, 2003.
The July 27, 1992 edition of the ADP Manual, 6010.50-M, is available online. This edition reissued the ADP Manual and supersedes the July 27, 1992 edition. All changes to the July 27, 1992 edition (through Change 81 dated May 18, 1999) have been incorporated.
The Automated Data Processing and Reporting (ADP) Manual defines the contractor's responsibilities related to the automated collection and transmission of relevant data between the contractor, the TRICARE Management Activity (TMA), and the Defense Enrollment Eligibility Reporting System (DEERS). The ADP Manual provides guidance and processes on the information flowing between the contractor and TMA which includes treatment encounters, provider data, pricing data and financial data. The ADP Manual defines the exchange of eligibility data to and from DEERS, the operation of the Central Deductible and Catastrophic Cap File (CDCF), and guidelines and documentation for the Duplicate Claims System. It also defines the related editing applied to ensure data validity for all of the above systems.
No future changes will be published to this edition.
Last Updated: October 22, 2004
Most Recent Change Number: Change 51

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Page Count: 1,240
Summary of Changes: This change provides the FY 2005 updates to the DRG and reimbursement systems. This change is published in conjunction with Mar 2002 TRM Change 37.


July 27, 1992 edition - Superseded

The July 27, 1992 edition of the ADP Manual, 6010.50-M, is available online in a limited capacity. The user can only view/save Changes 44 (March 1, 1996) through 81 (May 18, 1999).
The "Entire Change Package" option indicates that the entire change package was small enough to be contained in one file; however, if it is a large change package the package will be divided into parts. (Example: Part 1: Chap 1 - 3, Part 2: Add A - C, etc.). Legend for abbreviations used below: Chap = Chapter, Sec = Section, Add = Addendum, Tbl = Table, TOC = Table of Contents, Pgs = Pages.
No future changes will be published to this edition.
Last Updated: May 18, 1999
Most Recent Change Number: Change 81

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Page Count: 0
Summary of Changes: This change creates a special processing code "KO" to be used to identify all claims for family members of reservists activated for Operation Allied Force (Kosovo).