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TRICARE Program Manuals - 2021 Edition (T-5)
TRICARE Operations Manual 6010.62-M, April 2021
TRICARE Policy Manual 6010.63-M, April 2021
TRICARE Reimbursement Manual 6010.64-M, April 2021
TRICARE Systems Manual 7950.4-M, April 2021
TRICARE Program Manuals - 2015 Edition (T-2017)
TRICARE Operations Manual 6010.59-M, April 2015
TRICARE Policy Manual 6010.60-M, April 2015
TRICARE Reimbursement Manual 6010.61-M, April 2015
TRICARE Systems Manual 7950.3-M, April 2015
Other Manuals
32 CFR 199 (DHA Version), December 2016
DoD Women, Infants, and Children (WIC) Overseas Program Policy Manual, July 2017
Duplicate Claims System (DCS) User Guide, June 2017
10 USC 55 (DHA Version), January 2007
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Superceded Manuals
TRICARE Operations Manual, Change 15, October 12, 2004
Page Count:
1,452
Summary of Changes:
This change is an administrative change to the MCS and TDEFIC contracts allowing for continued TRICARE coverage for retirees and their dependents who are under the age of 65 and who have Medicare Part A but not Medicare Part B. The FY05 National Defense Authorization Act extends TRICARE coverage until December 31, 2004 to those individuals who, because of disability or end stage renal disease, are eligible for Medicare Part A but did not obtain Part B.
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Chapter -- TO02 TOC
Chapter 1 -- Administration
Chapter 2 -- Records Management
Chapter 3 -- Financial Administration
Chapter 4 -- Provider Certification And Credentialing
Chapter 5 -- Provider Networks
Chapter 6 -- Enrollment
Chapter 7 -- Utilization And Quality Management
Chapter 8 -- Claims Processing Procedures
Chapter 9 -- TRICARE Duplicate Claims System - HCSR Version
Chapter 10 -- TRICARE Duplicate Claims System - TED Version
Chapter 11 -- Claims Adjustments And Recoupments
Chapter 12 -- Beneficiary And Provider Services
Chapter 13 -- Appeals And Hearings
Chapter 14 -- Program Integrity
Chapter 15 -- Audits, Inspections, And Reports
Chapter 16 -- Regional Director/MTF And Contractor Interfaces
Chapter 17 -- TRICARE Prime Remote Program
Chapter 18 -- Civilian Care Referred By MHS Facilities
Chapter 19 -- Civilian Health Care Of Uniformed Service Members
Chapter 20 -- Demonstrations
Chapter 21 -- Health Insurance Portability And Accountability Act of 1996 (HIPPA)
Chapter 22 -- TRICARE Dual Eligible Fiscal Intermediary Contract
Chapter 23 -- TRICARE Alaska
TRICARE Policy Manual, Change 11, September 29, 2004
Page Count:
956
Summary of Changes:
See the
Change Transmittal
for a detailed summary. This change is published in conjunction with
Aug 2002 TSM Change 17
.
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Table of Contents at Change 11
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Chapter -- TP02 TOC
Chapter 1 -- Administration
Chapter 2 -- Evaluation And Management
Chapter 3 -- Anesthesia
Chapter 4 -- Surgery
Chapter 5 -- Radiology
Chapter 6 -- Pathology And Laboratory
Chapter 7 -- Medicine
Chapter 8 -- Other Services
Chapter 9 -- Program For Persons With Disabilities (PFPWD)
Chapter 10 -- Eligibility And Enrollment
Chapter 11 -- Providers
Chapter 12 -- TRICARE Overseas Program (TOP)
TRICARE Reimbursement Manual, Change 14, October 6, 2004
Page Count:
1,394
Summary of Changes:
This change provides the FY2005 updates to: 1) inpatient mental health rates and cost-share; 2) RTC per diem rates; 3) hospice rates and wage indexes; 4) partial hospitalization rates; 5) SNF rates and wage indexes; 6) birthing center rates; 7) inpatient active duty dependent cost-share; and 8) inpatient cost-share per diem for beneficiaries other than dependents of active duty members. This change also corrects Chapter 4, Section 4 (Coordination of Benefits), Example 4 removes Gulf Coast Treatment Center, Inc. as an authorized RTC.
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Chapter -- TR02 TOC
Chapter 1 -- General
Chapter 2 -- Beneficiary Liability
Chapter 3 -- Operational Requirements
Chapter 4 -- Double Coverage
Chapter 5 -- Allowable Charges
Chapter 6 -- Diagnostic Related Groups (DRGs)
Chapter 7 -- Mental Health
Chapter 8 -- Skilled Nursing Facilities (SNFs)
Chapter 9 -- Ambulatory Surgery Centers (ASCs)
Chapter 10 -- Birthing Centers
Chapter 11 -- Hospice
Chapter 12 -- Home Health Care
TRICARE Systems Manual, Change 17, September 29, 2004
Page Count:
1,090
Summary of Changes:
This change updates the procedure codes modifiers in the table Code/Value Specification and updates the 2004 procedure codes for type of service. This change is published in conjunction with
Aug 2002 TPM Change 11
.
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Table of Contents at Change 17
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Chapter -- Master TOC
Chapter 1 -- General ADP Requirements
Chapter 2 -- TRICARE Encounter Data (TED)
Chapter 3 -- DEERS
Chapter 4 -- Query For Deductible And Catastrophic Cap
32 CFR 199, Change 27, October 12, 2004
Page Count:
526
Summary of Changes:
Final Rule
- Changes included in the National Defense Authorization Act for Fiscal Year 2002 (NDAA-02) and a technical correction included in the NDAA-03.
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Chapter -- Acronyms (Code of Federal Regulations)
Chapter 199.1 -- General Provisions (Code of Federal Regulations)
Chapter 199.2 -- Definitions (Code of Federal Regulations)
Chapter 199.3 -- Eligibility (Code of Federal Regulations)
Chapter 199.4 -- Basic Program Benefits (Code of Federal Regulations)
Chapter 199.5 -- Program For Persons With Disabilities (PFPWD) (Code of Federal Regulations)
Chapter 199.6 -- Authorized Providers (Code of Federal Regulations)
Chapter 199.7 -- Claims Submission, Review, And Payment (Code of Federal Regulations)
Chapter 199.8 -- Double Coverage (Code of Federal Regulations)
Chapter 199.9 -- Administrative Remedies For Fraud, Abuse, And Conflict Of Interest (Code of Federal Regulations)
Chapter 199.10 -- Appeals And Hearings Procedures (Code of Federal Regulations)
Chapter 199.11 -- Overpayments Recovery (Code of Federal Regulations)
Chapter 199.12 -- Third Party Recoveries (Code of Federal Regulations)
Chapter 199.13 -- TRICARE Dental Program (Code of Federal Regulations)
Chapter 199.14 -- Provider Reimbursement Methods (Code of Federal Regulations)
Chapter 199.15 -- Quality And Utilization Review Peer Review Organization Program (Code of Federal Regulations)
Chapter 199.16 -- Supplemental Health Care Program For Active Duty Members (Code of Federal Regulations)
Chapter 199.17 -- TRICARE Program (Code of Federal Regulations)
Chapter 199.18 -- Uniform HMO Benefit (Code of Federal Regulations)
Chapter 199.19 -- Reserved (Code of Federal Regulations)
Chapter 199.20 -- Continued Health Care Benefit Program (CHCBP) (Code of Federal Regulations)
Chapter 199.21 -- Pharmacy Benefits Program (Code of Federal Regulations)
Chapter 199.22 -- TRICARE Retiree Dental Program (TRDP) (Code of Federal Regulations)
Chapter 199.23 -- Special Supplemental Food Program (Code of Federal Regulations)
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