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TRICARE Policy Manual 6010.60-M, April 1, 2015
Evaluation And Management
Chapter 2
Section 5.1
Issue Date:  March 3, 1992
Copyright:  CPT only © 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved.
Revision:  C-100, August 3, 2022
99241 - 99255, 99446 - 99449, 99451, 99452
A deliberation with a specialist physician, dentist, or qualified mental health provider requested by the attending physician primarily responsible for the medical care of the patient, with respect to the diagnosis or treatment in any particular case.
3.1  TRICARE covers consultations performed by a TRICARE-authorized, individual professional provider at the request of the patient’s attending provider.
3.2  A consulting physician, dentist, or qualified mental health provider may perform a limited examination of a given system or one requiring a complete diagnostic history and examination.
3.3  The contractor shall require a written report to the attending physician of the consultant’s findings to cover a visit as a consultation.
3.4  TRICARE covers interprofessional Internet consultations conducted via the Internet and telephone (Current Procedural Terminology (CPT) codes 99446-99449, 99451, and 99452), including a verbal and written report to the patient’s treating/requesting physician or other TRICARE-authorized provider. See Chapter 7, Section 22.1.
4.1  Telephone toll charges are not covered.
4.2  Staff consultations required by the policies of a hospital or other institution.
5.0  Effective Dates
5.1  May 12, 2020, for telephonic consultations during the Coronavirus Disease 2019 (COVID-19) pandemic.
5.2  July 1, 2022, for telephonic consultations.
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