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TRICARE Policy Manual 6010.60-M, April 1, 2015
Extended Care Health Option (ECHO)
Chapter 9
Section 9.1
Special Education And Other Services
Issue Date:  July 3, 1997
Authority:  32 CFR 199.5(c)(3) and (c)(4)
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-27, July 26, 2018
1.0  CPT PROCEDURE CODES
99199, 99600
2.0  POLICY
2.1  Special education, within the meaning of such term as used in the Individuals with Disabilities Education Act (IDEA) and its implementing regulations and policies, may be cost-shared subject to all applicable Extended Care Health Option (ECHO) requirements, and in particular, the requirement that other public programs and facilities be used to the extent available and adequate.
2.2  Identification of appropriate public facilities. The local educational agency with responsibility for the beneficiary is the sole public facility to provide public facility use certification for special education services.
2.3  Services cost-shared through the ECHO may be provided by an authorized institutional or individual professional provider on an inpatient or outpatient basis and rendered in the beneficiary’s natural environment. This includes at home, at school, or other location that is suitable for the type of services being rendered.
3.0  EXCLUSION
Special education services are generally unavailable under the TRICARE Basic Program except as authorized under Section 1079(a)(g) of Title 10 United States Code (USC), and when authorized are not eligible to be cost-shared under ECHO.
4.0  EFFECTIVE DATE
September 1, 2005.
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