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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 3, April 26, 2024

Summary of Changes: This change broadens pay center language beyond DFAS, PHS and CG to anticipate additional pay centers coming online. This change is published in conjunction with TRICARE Systems Manual 7950.3-MX, April 2021 Change 1.
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TRICARE Policy Manual, Change 2, April 30, 2024

Summary of Changes: This change updates TRICARE's lung cancer and colorectal cancer preventive screening guidelines based on the most current USPSTF recommendations and updates vision screening based on a review of the codes in that section.
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TRICARE Reimbursement Manual, Change 2, April 23, 2024

Summary of Changes: This change implements a TRICARE-specific DMEPOS fee schedule for certain DME items that have no Medicare rates. This change is published in conjunction with TRICARE Policy Manual 6010.64-M, April 2021 Change 1.
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TRICARE Systems Manual, Change 1, April 26, 2024

Summary of Changes: This change broadens pay center language beyond DFAS, PHS and CG to anticipate additional pay centers coming online. This change is published in conjunction with TRICARE Operations Manual 6010.63-M, April 2021 Change 3.
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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The Managed Care Support (MCS) Manuals (T-3) for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.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 135, April 22, 2024

Summary of Changes: This change provides updates as a result of DoDIG audit.
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TRICARE Policy Manual, Change 125, March 18, 2024

Summary of Changes: See summary details below.
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TRICARE Reimbursement Manual (TRM), Change 77, March 25, 2024

Summary of Changes: This change updates applicability for Ambulatory Surgery Center reimbursement policy and General Temporary Military Contingency Payment Adjustment language regarding hold harmless payments and the Outpatient Prospective Payment System year dates.
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TRICARE Systems Manual, Change 78, May 2, 2024

Summary of Changes: This change includes 2 new Special processing codes RP and SD. RP - Mail Order Pharmacy (MOP), Specialty Clinical Services, Drugs Dispensed and SD - Mail Order Pharmacy (MOP) Specialty Supportive Drugs Dispensed. Also RP and SD have been added to two edits 2-305-33R and 2-30-48R.
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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 18, April 4, 2023

Summary of Changes: Final Rule - TRICARE; Reimbursement of Ambulatory Surgery Centers and Outpatient Services Provided in Cancer and Children's Hospitals
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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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