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TRICARE Program Manuals - 2021 Edition (T-5)

These manuals are applicable to the T-5 East and West Regional Managed Care Support Contracts (MCSCs) (HT940223C0001 and HT940223C0002). Upon direction of the respective Contracting Officer (CO), all or portions of these manuals may also apply to other TRICARE contracts.

TRICARE Operations Manual, Change 36, January 17, 2025

Summary of Changes: This change directs the payment of enrollment fees via allotment from military pay, where feasible, for new TRICARE Prime Retiree Policies.
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TRICARE Policy Manual, Change 28, January 8, 2025

Summary of Changes: This change incorporates T17 published reimbursement and coding changes into the T5 Manuals. This change is published in conjunction with TRICARE Reimbursement Manual 6010.65-M, April 2021 Change 16; and TRICARE Systems Manual 7950.3-M, April 2021 Change 22.
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TRICARE Reimbursement Manual, Change 16, January 8, 2025

Summary of Changes: This change incorporates T17 published reimbursement and coding changes into the T5 Manuals. This change is published in conjunction with TRICARE Policy Manual 6010.64-M, April 2021 Change 28; and TRICARE Systems Manual 7950.3-M, April 2021 Change 22.
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TRICARE Systems Manual, Change 22, January 8, 2025

Summary of Changes: This change corrects a Provider Major Specialty Code and changes a Major Specialty Code Freestanding End Stage Renal Disease (ESRD) Facilities to 94. This change is published in conjunction with TRICARE Policy Manual 6010.64-M, April 2021 Change 28; and TRICARE Reimbursement Manual 6010.65-M, April 2021 Change 16.
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TRICARE Program Manuals - 2015 Edition (T-2017)

These manuals are applicable to the East and West Regional Managed Care Support Contracts (MCSCs) awarded on or after 07/21/2016. Upon direction of the Contracting Officer (CO), all or portions of these manuals may also apply to the TQMC, TCARS, TOP, TPharm, TDP, and TDEFIC.

The Managed Care Support (MCS) Manuals (T-3) for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.

TRICARE Operations Manual, Change 146, December 23, 2024

Summary of Changes: This change adds newly covered LDTs and moves the LDT list to the TRICARE rates and reimbursement website.
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TRICARE Policy Manual, Change 138, December 30, 2024

Summary of Changes: This change provides updates to include provisional coverage of monoclonal antibody drugs for Alzheimer's disease and mild cognitive impairment. This change is published in conjunction with TRICARE Systems Manual 7950.3-M, April 2015 Change 85.
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TRICARE Reimbursement Manual (TRM), Change 84, October 16, 2024

Summary of Changes: See summary details below.
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TRICARE Systems Manual, Change 85, December 30, 2024

Summary of Changes: This change provides updates to include provisional coverage of monoclonal antibody drugs for Alzheimer's disease and mild cognitive impairment. This change is published in conjunction with TRICARE Policy Manual 6010.60-M, April 2015 Change 138.
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Other Manuals

Authority for the TRICARE Program is the 32 CFR 199. DHA is providing a version of Title 32 to the Code of Federal Regulations, Part 199 (32 CFR 199) and 10 United States Code Chapter 55 as a convenience for the DHA community.

32 CFR 199 (2016), Change 19, May 24, 2024

Summary of Changes: Final Rule - TRICARE; Removal of Certain Temporary Regulation Changes Made in Response to COVID-19
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10 USC 55, Change 9, June 27, 2018

Page Count: 518
Summary of Changes: USC Classification Table, 115th, First Session (Public Laws 115-1 through 115-117)
—Prepared by Office of the Law Revision Counsel, U.S. House of Representatives (January 12, 2018).
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DCS User Guide, Baseline, June 1, 2017

Page Count: 202
Summary of Changes: This is the June 2017 Duplicate Claims System (DCS) User Guide.
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Not available for this change

DoD WIC Overseas Program Policy Manual, Baseline, July 1, 2017

Page Count: 27
Summary of Changes: This is the July 2017 WIC Overseas Program Policy Manual
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Not available for this change

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