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TRICARE Program Manuals - 2015 Edition (T-2017)

These manuals are applicable to the East and West Regional Managed Care Support Contracts (MCSCs) awarded on or after 07/21/2016. Upon direction of the Contracting Officer (CO), all or portions of these manuals may also apply to the TQMC, TCARS, TOP, TPharm, TDP, and TDEFIC.

TRICARE Operations Manual, Baseline, April 1, 2015

Page Count: 1,094
Summary of Changes: This is the baseline version of the April 2015 TRICARE Operations Manual.

TRICARE Policy Manual, Baseline, April 1, 2015

Page Count: 1,024
Summary of Changes: This is the baseline version of the April 2015 TRICARE Policy Manual.

TRICARE Reimbursement Manual (TRM), Baseline, April 1, 2015

Page Count: 1,048
Summary of Changes: This is the baseline version of the April 2015 TRICARE Reimbursement Manual.

TRICARE Systems Manual, Baseline, April 1, 2015

Page Count: 768
Summary of Changes: This is the baseline version of the April 2015 TRICARE Systems Manual.

TRICARE Program Manuals - 2008 Edition (T-3)

These manuals serve for contracts awarded on or after 06/27/2008 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The MCS Manuals for contracts prior to 06/26/2008 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.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.

TRICARE Operations Manual, Change 199, November 29, 2016

Page Count: 1,616
Summary of Changes: This change adds language to allow Doctors in Nursing Practice as meeting the specific qualifications as specialized Autism Spectrum Disorder diagnosing providers under the Comprehensive Autism Care Demonstration. Behavior Technicians still must obtain ongoing supervision for a minimum of 5% of the hours spent providing one-on-one ABA services, now per a 30 consecutive day period per beneficiary; remote supervision is approved. This change will also require the contractor to deny claims for providers who are not Basic Life Support/Cardiopulmonary Resuscitation certified and for BTs not certified by January 1, 2017.

TRICARE Policy Manual, Change 175, November 7, 2016

Page Count: 1,120
Summary of Changes: This change modifies the current policy on Auditory Osseointegrated Implant Devices and finds them to be prosthetic devices, rather than hearing aids.

TRICARE Reimbursement Manual, Change 134, November 8, 2016

Page Count: 1,080
Summary of Changes: This change (1) formalizes the process by which exceptions are made to TRICARE's inpatient only list; (2) establishes that TRICARE for Life beneficiaries are not eligible for exceptions to protect them from financial liability; and (3) establishes that the TRICARE Inpatient Only List no longer applies to hospital outpatient departments in the state of Maryland.

TRICARE Systems Manual, Change 90, August 15, 2016

Page Count: 958
Summary of Changes: See the Change Transmittal. This change is published in conjunction with Feb 2008 TOM Change 191.

Other Manuals

Authority for the TRICARE Program is the 32 CFR 199. DHA is providing a version of Title 32 to the Code of Federal Regulations, Part 199 (32 CFR 199) and 10 United States Code Chapter 55 as a convenience for the DHA community.

32 CFR 199 (2005), Change 74, November 2, 2016

Page Count: 526
Summary of Changes: Final Rule: Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)/TRICARE: Refills of Maintenance Medications Through Military Treatment Facility Pharmacies or National Mail Order Pharmacy Program

32 CFR 199 (2016), Baseline, December 1, 2016

Page Count: 502
Summary of Changes: This is the baseline version of the December 2016 32 CFR 199 (DHA Version).

10 USC 55, Change 7, June 8, 2016

Page Count: 456
Summary of Changes: USC Classification Table, 114th, First Session (Public Laws 114-1 through 114-115)
—Prepared by Office of the Law Revision Counsel, U.S. House of Representatives (January 3, 2016).

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CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.

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If you need help with technical/operational issues, please go to the TRICARE Manuals Online Help Resources page.

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