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The Managed Care Support (MCS) Manuals (T-3) for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.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 138, May 21, 2024
Summary of Changes: This change clarifies direction to contractors regarding PCM changes versus when dis-enrollment is appropriate, as well as understanding contractor responsibilities for split claims. This change is published in conjunction with
TRICARE Policy Manual 6010.60-M, April 2015 Change 126.
TRICARE Policy Manual, Change 127, May 24, 2024
Summary of Changes: This change clarifies that “medically necessary mastectomy” may include partial mastectomy such as lumpectomy.
TRICARE Reimbursement Manual (TRM), Change 78, May 20, 2024
Summary of Changes: This change standardizes wording to consistently refer to TRICARE-designated percentage amounts for NTAPS.
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.