These manuals serve for contracts awarded on or after 06/27/2008 for the North, South, and West Regions along with TQMC, CARS, TOP, and TPharm. The manuals will apply to the TDEFIC contract upon direction of the Contracting Officer
The MCS Manuals for contracts prior to 06/26/2008 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual. For the ADP Manual, select the TSM Manual.
TRICARE Operations Manual, Change 224, June 19, 2018
Page Count: 1,636
Summary of Changes: This change adds language stating there is a waiver to the TRICARE Overseas Program (TOP) contractor to allow a provider to retain good faith payments in certain cases.
TRICARE Policy Manual, Change 203, June 14, 2018
Page Count: 1,084
Summary of Changes: This change clarifies when beneficiaries (e.g., foreign military, TRICARE premium plan users) are in Group A or Group B for cost-shares, deductibles and catastrophic cap, corrects errors in original TRICARE Select change and adds language regarding Referrals and Preauthorization. This change is published in conjunction with
Feb 2008 TOM Change 223,
Feb 2008 TRM Change 160, and
Feb 2008 TSM Change 106.
TRICARE Reimbursement Manual, Change 160, June 14, 2018
Page Count: 1,096
Summary of Changes: This change clarifies when beneficiaries (e.g., foreign military, TRICARE premium plan users) are in Group A or Group B for cost-shares, deductibles and catastrophic cap, corrects errors in original TRICARE Select change and adds language regarding Urgent Care. This change is published in conjunction with
Feb 2008 TOM Change 223,
Feb 2008 TPM Change 203, and
Feb 2008 TSM Change 106.
TRICARE Systems Manual, Change 107, June 21, 2018
Page Count: 972
Summary of Changes: This change adds new adjustments/denials, reason codes, new country codes, TED record format changes and edit clean up. This change also updates HCDP plan coverage codes, begin date of care and enrollment health plan codes.