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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