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The Managed Care Support (MCS) Manuals for contracts prior to 07/21/2016 are now superseded and can be found in the "Superseded" portion (indicated by a red banner) of each manuals' web page. Select the desired manual below, then proceed to the "Superseded" manual(s) that exist below the "Current" manual.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 29, June 20, 2018
Page Count: 1,172
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 26, June 25, 2018
Page Count: 994
Summary of Changes: This is a correction to Evolving Practice 18-001. This change deletes language on cervical laminoplasty and adds language regarding transcatheter placement of intravascular stent(s) that was inadvertently deleted.
TRICARE Reimbursement Manual (TRM), Change 22, June 15, 2018
Page Count: 970
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
Apr 2015 TOM Change 28,
Apr 2015 TPM Change 25, and
Apr 2015 TSM Change 15.
TRICARE Systems Manual, Change 16, June 22, 2018
Page Count: 702
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.