Providers
Chapter 11
Section 2.4
Eating Disorder Programs
Issue Date: July 19, 1983
Revision: C-72, October 16, 2020
1.0 DESCRIPTION
An eating disorder program is an institutionally
based regimen for the treatment of those mental disorders which
are characterized by gross disturbances in eating behavior.
2.0 POLICY
2.1 An eating
disorder program provided within an institutional facility that
meets the requirements to be certified as a TRICARE-authorized institutional
provider is covered. For example, a Residential Treatment Center
(RTC) or Partial Hospitalization Program (PHP) may be covered as
an authorized institutional provider. (See
Section 2.5 for
PHP certification requirements and
Section 2.9 for RTC
certification requirements).
2.2 Medically necessary
outpatient eating disorder services may be covered when rendered
by a TRICARE-authorized individual professional provider listed
in 32 CFR 199.6(c) or by a TRICARE-authorized
institutional provider.
2.3 Eating disorder services rendered in a freestanding
eating disorder program that fails to meet the certification requirements
of one of the institutional provider categories listed on
32 CFR 199.6(b) are excluded from coverage.
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