TRICARE Reimbursement Manual 6010.61-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 Reimbursement Manual (TRM) is incorporated by reference in the Managed Care Support Contracts (MCSCs) and is the primary vehicle for operating guidelines and instructions. The TRM provides a mechanism for keeping the contracts current by clarifying or modifying existing contractual requirements, adding new specifications/requirements and deleting obsolete information. The TRM, in conjunction with the April 2015 TRICARE Policy Manual (TPM), provides guidance, policy interpretation, and decisions implementing TRICARE, including those policies and procedures applicable to the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). The TRM contains operational policy necessary to implement Title 32 to the Code of Federal Regulations Part 199 (32 CFR 199). This manual augments the 32 CFR 199 and must be used in conjunction, for complete policy information.

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 Reimbursement Manual (TRM), 6010.61-M, is available online.
All future changes will be published to this edition.
Last Updated: October 16, 2020
Most Recent Change Number: Change 50


Page Count: 934
Summary of Changes: The 2017 National Defense Authorization Act (NDAA), Section 701 requires the Department of Defense to replace TRICARE Extra and Standard with a new healthcare plan called TRICARE Select as of January 1, 2018. Continuous enrollment will shift to an open season, similar to Medicare. The enrollment year will based on a calendar year versus a fiscal year. Beneficiary fees will be calculated based on when the sponsors initial period of service (before January 1, 2018 or on or after January 1, 2018). This change is published in conjunction with Apr 2015 TOM Change 6, Apr 2015 TPM Change 9, and Apr 2015 TSM Change 4.