Back to Top Skip to main content

Health.mil: the official website of the Military Health System (MHS) and the Defense Health Agency (DHA)

Utility Navigation Links

TRICARE Policy Manual 6010.60-M, April 1, 2015
Providers
Chapter 11
Section 4.1
Unauthorized Institution: Related Professional Services
Issue Date:  January 26, 1987
Authority:  32 CFR 199.6(c)
Revision:  
1.0  POLICY
Otherwise covered services rendered by an authorized professional provider who is not employed by or contracted with the institution may be cost-shared even though the medical services were furnished in an unauthorized institution for which benefits cannot be extended.
2.0  EXCLUSION
Inpatient mental health services, partial hospitalization, or any other care that falls under the waiver of liability provision. For example, when preauthorization is required as for inpatient mental health services and partial hospitalization and has not been obtained, payment may not be made for any of the services, either institutional or those rendered by an authorized professional provider who is not employed or contracted with the institution.
- END -

Utility Navigation Links

DoD Seal

tricare.mil is the official website of the Defense Health Agency (DHA) a component of the Military Health System

TRICARE is a registered trademark of the Department of Defense (DoD), DHA. All rights reserved.

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

If you have a question regarding TRICARE benefits, please go to the TRICARE Contact Us page page.
If you need help with technical/operational issues, please go to the TRICARE Manuals Online Frequently Asked Questions page.

The appearance of hyperlinks to external websites does not constitute endorsement by the DHA of these websites or the information, products or services contained therein. For other than authorized government activities, the DHA does not exercise any editorial control over the information you may find at other locations. Such links are provided consistent with the stated purpose of this DoD website.

v4.8.7983.18738

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.