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TRICARE Systems Manual 7950.2-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 Systems Manual (TSM) is incorporated by reference in the Managed Care Support Contracts (MCSCs) and is the primary vehicle for systems requirements and instructions. The TSM provides a mechanism for keeping the contracts current by clarifying or modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. The TRICARE Systems Manual (TSM), 7950.3-M, defines contractor responsibilities for automated processing of health care information, reporting and transmission of relevant data between the contractor and the Defense Health Agency (DHA). The manual also provides requirements for 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. Requirements for the TRICARE Encounter Data (TED) and the TRICARE Duplicate Claims System (DCS) – TRICARE Encounter Data (TED) Version are located in this manual.

NOTE

The Managed Care Support (MCS) Manuals for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.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: October 18, 2022
    Most Recent Change Number: Change 63

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    This change adds/updates codes/code values and updates an end date in order to keep the TSM aligned with the TED system and to keep the contractors from failing edits.
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  • February 1, 2008 Edition - Superseded
    Last Updated: October 17, 2022
    Most Recent Change Number: Change 148
    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.
    Change 3 and 4 only: Chapter 1, Addendum B has been removed because of restricted access. When trying to access this file using the Table of Contents for Chapter 1, a message will be received stating that the file cannot be found (404 error). For a copy of the Addendum, contact the Chief Contract Acquisition Branch, Richard Van Dorn.
    This edition supersedes the August 1, 2002 edition. All changes to the August 1, 2002 edition (through Change 102 dated April 3, 2013) have been incorporated.
    No future changes will be published to this edition.

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    Page Count: 974
    This change adds/updates codes/code values and updates an end date in order to keep the TSM aligned with the TED system and to keep the contractors from failing edits.
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  • August 1, 2002 Edition - Superseded
    Last Updated: April 3, 2013
    Most Recent Change Number: Change 102
    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.

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