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TRICARE Reimbursement Manual 6010.61-M

Each TRICARE Manual posted on the website incorporates all published changes. Although changes are published, they are not implemented by the contractors until they receive direction to do so by the Contracting Officer. Each TRICARE Manual on the web incorporates all changes by the date of publication. Although changes are published, they may not be implemented by the contractor until directed to do so by the Contracting Officer.
The TRICARE Reimbursement Manual (TRM) is incorporated by reference in the Managed Care Support Contracts (MCSCs) and is the primary vehicle for operating guidelines and instructions. The TRM provides a mechanism for keeping the contracts current by clarifying or modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. The TRM, in conjunction with the April 2015 TRICARE Policy Manual (TPM), provides guidance, policy interpretation, and decisions implementing TRICARE, including those policies and procedures applicable to the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). The TRM contains operational policy necessary to implement Title 32 to the Code of Federal Regulations Part 199 (32 CFR 199). This manual augments the 32 CFR 199 and must be used in conjunction, for complete policy information.

NOTE

The Managed Care Support (MCS) Manuals (T-3) for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.

  • April 1, 2015 Edition
    Last Updated: June 4, 2024
    Most Recent Change Number: Change 79
    These manuals are applicable to the East and West Regional Managed Care Support Contracts awarded on or after 07/21/2016. Upon direction of the Contracting Officer, all or portions of these manuals may also apply to the TRICARE Quality Monitoring Contract (TQMC), TRICARE Claims Audit Review Services (TCARS), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm), TRICARE Dental Program (TDP), and TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC).
    This edition reissued the February 1, 2008 edition. All changes to the February 1, 2002 edition of the TRM (through Change 200 dated August 2, 2022) have been incorporated.
    All future changes will be published to this edition.

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    See summary details below. This change is published in conjunction with TRICARE Policy Manual 6010.60-M, April 2015 Change 128.
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  • February 1, 2008 Edition - Superseded
    Last Updated: August 2, 2022
    Most Recent Change Number: Change 200
    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.
    This edition supersedes the August 1, 2002 edition. All changes to the August 1, 2002 edition (through Change 159 dated April 3, 2013) have been incorporated.
    No future changes will be published to this edition.

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    Page Count: 1,096
    This change clarifies when beneficiaries (e.g., foreign military, TRICARE premium plan users) are in Group A or Group B for cost-shares, deductibles and catastrophic cap, corrects errors in original TRICARE Select change and adds language regarding Urgent Care. This change is published in conjunction with Feb 2008 TOM Change 223, Feb 2008 TPM Change 203, and Feb 2008 TSM Change 106.
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  • August 1, 2002 Edition - Superseded
    Last Updated: April 3, 2013
    Most Recent Change Number: Change 159
    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 Reimbursement Manual (TRM), 6010.55-M, is available online. This edition supersedes the March 15, 2002 edition. All changes to the March 15, 2002 edition (through Change 37 dated October 22, 2004) have been incorporated.
    No future changes will be published to this edition.

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    Page Count: 1,490
    See the Change Transmittal. This change is published in conjunction with Aug 2002 TPM Change 175 and Aug 2002 TSM Change 102.
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