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TRICARE Reimbursement Manual 6010.64-M, April 2021
General
Chapter 1
Section 30
Reimbursement Of Travel Expenses For Specialty Care
Issue Date:  December 21, 2001
Authority:  32 CFR 199.17(n)(2)(vii); JTR, Ch3, Part D; Public Law 110-181 Section 1632 (which amended 10 USC 1074i); Public Law 111-281 Section 203
Revision:  C-1, April 16, 2024
1.0  POLICY
1.1  Non-active duty TRICARE Prime and TRICARE Prime Remote (TPR) enrollees referred for non-emergent medically necessary specialty care over 100 miles (one way) from their Primary Care Manager’s (PCM’s) office to the nearest specialist’s office may be eligible to receive reimbursement for reasonable travel expenses. Entitlement is limited to those specialty referrals when no other specialist (e.g., Market/Military Medical Treatment Facility (MTF), network or non-network specialists) is available within 100 miles (one way) of the PCM’s office. Depending on enrollment, the TRICARE Prime Travel Benefit (PTB) Office or the Market/MTF will determine if the specialty care is more than 100 miles (one way) from the provider’s office. PTB does not apply to a dependent Outside of the continental United States (OCONUS) or to an Active Duty Service Member (ADSM) who is authorized medical travel. For TRICARE Prime Remote Active Duty Family Member (TPRADFM) enrollees with unassigned PCM, 100 miles is determined from the referring provider’s office to the specialty provider.
1.2  Prime Travel Benefit (PTB) Program Attestations - The contractor shall provide an attestation that confirms the contractor verified the referred specialist is 100 miles or more from the PCM (or referring provider for TPRADFM unassigned beneficiaries) and there are no suitable providers to meet the patient’s needs within 100 miles of the PCM within appointment access to care (ATC) standards. The contractor shall provide a daily spreadsheet and weekly reports with any information needed to assist in validating beneficiary eligibility trip qualification requirements for TRICARE Prime travel reimbursement. For reporting requirements, see DD Form 1423, Contract Data Requirements List (CDRL), located in Section J of the applicable contract. Each beneficiary entry shall be in the report is called an “attestation. and shall The daily report, provided to the Defense Health Agency (DHA)/Prime Travel Section, includes information related to network-enrolled beneficiaries or any non-Active Duty Service Member (ADSM) United States Coast Guard (USCG) enrolled beneficiaries (network or direct care) who received approved authorizations for specialty care over 100 miles from the PCM’s Office. The weekly report, provided to each Market/MTF, includes information related to the non-ADSM Market/MTF enrolled beneficiaries except USCG beneficiaries.
1.2.1  The contractor shall respond to all beneficiary inquiries regarding authorization questions.
1.2.2  TheFor non-active duty network enrolled and all USCG beneficiaries, the contractor shall resolve access to care issues, including but not limited to, assigned Specialty Care Provider (SCP), SCP capability issues, and beneficiaries beneficiary’s need for additional letters of medical necessity justification. The Government will perform all operational functions to include distance validation and final program eligibility determination.
1.2.3  When a manual attestation is requested, the contractor shall provide the attestation, or a request for additional information, within three business days 90% of the time. The Government will request a manual attestation when an attestation is missing from the PTB Program attestation reports.
1.2.4  For non-active duty (AD) network and all USCG beneficiaries, when the original attestation is contested and upon request by the beneficiary, by either direct inquiry to the contractor or forwarded by the DHA, the contractor shall perform a medical review of all available documentation, to include additional provider justification letters, to determine if there is medical justification to be evaluated and treated by the selected specialty provider.
1.2.4.1  For non-AD network and all USCG beneficiaries, the contractor shall respond to beneficiary inquiries requesting medical review assessment. The contractor shall forward the medical review assessment and determination to the DHA PTB Section within 14 calendar days of receipt of the beneficiary’s provider justification letter. The contractor shall provide additional clinical documentation upon request from the DHA PTB Section.
1.2.4.2  If the contractor determines there are other qualified providers located within 100 miles of the PCM, the contractor shall provide the beneficiary with that specialty provider contact information.
1.3  The contractor shall refer inquires about travel reimbursement for non-TRICARE Prime enrolled retirees with combat-related disabilities to the DHA PTB Section. A retiree with a combat-related disability (as determined by the member’s Branch of Service), not enrolled in TRICARE Prime, and referred by a Primary Care Provider (PCP) for follow-on specialty care related to that specific disability as listed in Combat-Related Special Compensation (CRSC) letter, more than 100 miles (one way) from where the PCP provides services to the retiree, may be eligible to receive reimbursement for reasonable travel expenses. The TRICARE DHA PTB Office Section for the geographical area in which the retiree resides will determine if the specialty care is more than 100 miles (one way) from the provider’s office.
1.4  The contractor shall refer inquiries about travel reimbursement for retirees with combat-related disabilities to the TRICARE PTB Office or Beneficiary Counseling and Assistance Coordinator (BCAC) for further information and assistance.
1.4  The contractor shall refer inquiries about travel reimbursement for USCG beneficiaries to the DHA PTB Section travel representative. The Coast Guard Authorization Act of 2010, signed into law on October 15, 2010, authorizes reimbursement for travel to specialty care less than 100 miles (one way) for a non-active duty Coast Guard USCG beneficiary (active duty dependents only) who resides on an island within the continental United States (CONUS), with no public access roads to the mainland, and for one medically necessary attendant. Entitlement is limited to those specialty referrals when no other specialist (e.g., Market/MTF, network or non-network specialists) is available on the island. The beneficiary must be enrolled in TRICARE Prime or TPRADFM and referred to a specialty care provider by their PCM. The contractor shall refer inquiries about travel reimbursement for Coast Guard beneficiaries to the appropriate PTB travel representative.
1.6  For patients eligible for travel reimbursement under paragraphs 1.1 through 1.5, if the PCM/PCP or servicing provider deems it medically necessary, travel orders and reimbursement may be authorized for one Non-Medical Attendant (NMA) to accompany a non-active duty patient referred for applicable specialty care. The NMA must be a parent, legal guardian, spouse, or other adult member of the patient’s family, or other adult companion who has been delegated a medical Power of Attorney (POA) by the patient or legally responsible party. In most cases, the NMA’s must be at least 21 years old. The Medical POA may be waived at Approving Official (AO) discretion.
1.7  Except for Coast Guard beneficiaries, Markets/MTFs will validate the travel expense entitlement and issue travel orders for specialty referrals issued by military PCMs, and the TRICARE PTB Office will validate the travel entitlement and issue travel orders for specialty referrals from civilian PCMs. Travel reimbursements allowed under paragraphs 1.1 through 1.5 will be reimbursed in accordance with the Joint Travel Regulations (JTR). Travel reimbursement claims must be filed no later than one year after the qualifying travel date (exceptions may be made for patients eligible for travel reimbursement under paragraph 1.3). Travel expenses will not be authorized for elective procedures or non-covered benefits.
1.5  The Government determines if a beneficiary qualifies for the PTB or not. The contractor shall (except for Coast Guard beneficiaries-see paragraph 1.9), shall refer all travel requests questions except those regarding authorization issues, to the appropriate Market/MTF for Market/MTF non-ADSM-enrolled TRICARE Prime beneficiaries, to the Markets/MTFs and non-ADSM civilian-enrolled along with all USCG TRICARE Prime beneficiary requests to the TRICARE DHA PTB Office Section. for authorization, orders and claim processing if it appears the beneficiary may be entitled to travel benefits. Non-Coast Guard beneficiaries with questions about these travel benefits and the NMA entitlement should contact their local Market/MTF or the TRICARE PTB Office or BCAC for assistance. Telephone numbers and addresses for Beneficiary Counseling and Assistance Coordinator (BCAC) are available on the TRICARE website at http://www.tricare.mil/bcacdcao.
1.9  The contractor shall refer inquiries about travel reimbursement for Coast Guard beneficiaries to the appropriate TRICARE PTB Office. This applies to Markets/MTFs and civilian-enrolled TRICARE Prime and TPR beneficiaries.
2.0  EFFECTIVE DATES
2.1  October 30, 2000, for TRICARE Prime enrollees.
2.2  January 1, 2008, for retirees with a combat-related disability.
2.3  October 15, 2010, for TRICARE Prime Coast Guard island dwellers.
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