TRICARE Manuals - Display Chap 11 Sect 1.1 (Change 70, Sep 10, 2020)

Providers

Chapter 11

Section 1.1

Providers - General

Issue Date: January 28, 1994

Authority: 32 CFR 199.2(b) and 32 CFR 199.6

Revision: C-62, April 22, 2020

1.0 POLICY

TRICARE benefits may be allowed for the following authorized providers: (For information on authorized providers refer to 32 CFR 199.2 and 32 CFR 199.6.)

1.1 Institutional Providers

Categories of institutional providers include:

• Hospitals, acute care, general and special.

• Organ transplantation centers.

• Organ transplant consortia.

• Hospitals, psychiatric.

• Hospitals, long-term (tuberculosis, chronic care, or rehabilitation).

• Skilled Nursing Facilities (SNFs).

• Residential Treatment Centers (RTCs).

• Christian Science sanatoriums.

• Infirmaries.

• Other special institutional providers.

• Freestanding Ambulatory Surgical Centers (ASCs).

• Birthing centers.

• Psychiatric and Substance Use Disorder (SUD) Partial Hospitalization Programs (PHPs).

• Hospice programs.

• Inpatient/Residential Substance Use Disorder Rehabilitation Facilities (SUDRFs).

• Intensive Outpatient Programs (IOPs), psychiatric, and SUD.

• Opioid Treatment Programs (OTPs).

1.2 Individual Professional Providers

Types of professional providers include:

1.2.1 Physicians

• Doctors of Medicine (M.D.)

• Doctors of Osteopathy (D.O.)

1.2.2 Dentists

1.2.3 Other Allied Health Professionals

• Clinical psychologist.

• Doctors of Optometry.

• Doctors of Podiatry or Surgical Chiropody.

• Certified Nurse Midwives (CNMs).

• Certified Nurse Practitioners (NPs).

• Certified Clinical Social Worker (CSW).

• Certified Psychiatric Nurse Specialist (CPNS).

• Certified Physician Assistants (PAs).

• Anesthesiologist Assistant (AA).

• Certified Registered Nurse Anesthetist (CRNA).

• Other individual paramedical providers.

• Licensed Registered Nurses (RNs).

• Licensed registered Physical Therapists (PTs) and Occupational Therapists (OTs).

• Licensed or certified Physical Therapist Assistants (PTAs) and Occupational Therapy Assistants (OTAs).

• Audiologists.

• Speech therapists (speech pathologists).

• Registered Dietitian (RD).

• Nutritionist.

• TRICARE Certified Mental Health Counselor (TCMHC).

1.2.4 Extramedical Individual Providers

• Certified marriage and family therapists.

• Pastoral counselors.

• Supervised Mental Health Counselor (SMHC).

• Christian Science practitioners and Christian Science nurses.

1.3 Other Providers

Categories include:

• Independent laboratory.

• Suppliers of portable x-ray services.

• Pharmacies.

• Ambulance companies.

• Medical equipment firms, medical supply firms.

• Mammography suppliers.

• State Vaccine Programs or State Vaccine Program entities (SVPs) as suppliers of vaccines.

1.4 Extended Care Health Option (ECHO) Providers

Categories include:

• ECHO inpatient care provider.

• ECHO outpatient care provider.

• ECHO durable equipment vendor.

1.5 Corporate Services Providers

1.6 Medicare-Certified Home Health Agencies (HHAs)

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

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