TRICARE Operations Manual 6010.59-M


Each TRICARE Manual on the web incorporates all changes by the date of publication. Although changes are published, they may not be implemented by the contractor until directed to do so by the Contracting Officer.
The TRICARE Operations Manual (TOM) is incorporated by reference into the Managed Care Support Contracts (MCSCs) and is the primary vehicle for operational guidelines and instructions to the contractor. The TOM provides a mechanism for clarifying and modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. All or portions of the TOM may also be incorporated by reference into other TRICARE contracts.

April 1, 2015 edition

These manuals are applicable to the East and West Regional Managed Care Support Contracts awarded on or after 07/21/2016. Upon direction of the Contracting Officer, all or portions of these manuals may also apply to the TRICARE Quality Monitoring Contract (TQMC), TRICARE Claims Audit Review Services (TCARS), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm), TRICARE Dental Program (TDP), and TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC).
The April 1, 2015 edition of the TRICARE Operations Manual (TOM), 6010.59-M, is available online.
All future changes will be published to this edition.
Last Updated: April 29, 2020
Most Recent Change Number: Change 65

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Page Count: 1,208
Summary of Changes: This change is clarifying the preauthorization requirements for Provisional Coverage of services and supplies, depending on the service or supply being covered, and specifically removing the preauthorization requirement for Digital Breast Tomosynthesis (also referred to as 3D mammograms) and Platelet Rich Plasma Injections. This change is published in conjunction with Apr 2015 TPM Change 63.