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Changes to TRICARE

The Military Health System (MHS) is modernizing to better serve you and respond to changes in law and policy. Over the coming months and years, you will see some significant changes to the TRICARE health plan.

Visit the TRICARE Website to Learn More

TRICARE is changing. Are you ready?

What has changed in the past year?

Upcoming Pharmacy Changes

  • Changes are coming soon to network pharmacies. Learn More
  • Pharmacy copayments will increase beginning Jan. 1, 2022. Learn More

What should I do to keep my health care plan updated?

Want to learn more?

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Pharmacy Inserts

Publication
11/16/2021

Pharmacy bag inserts for print with blue boarders. Notice of new copayments in effect on January 1, 2022. Links to www.tricare.mil/pharmacy for more information. Includes a QR code in the upper right corner and the TRICARE logo on the bottom right.

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TRICARE Pharmacy Program

Autism Care Demonstration Policy Changes: Question & Answers - Set 5

Publication
7/30/2021

Topics covered in Set 5 include: - CPT Codes - General - Concurrent Billing - CPT Code T1023 - Medical Team Conference (MTC) - CPT Code 97151 - CPT Code 97155 - CPT Code 97156 - CPT Code 97157/97158 - Clinical Necessity Reviews - ABA Discharge Summary

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Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Question & Answers - Set 4

Publication
7/27/2021

Topics covered in Set 4 include: - Provider Education - Audits - Autism Services Navigator (ASN) - Comprehensive Care Plan (CCP) - Reimbursements - Outcome Measures – General Questions - Documentation - Place of Service (PoS)

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Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 3

Publication
7/14/2021

Topics covered in Set 3 include: - Referrals and Authorizations - Parent Stress Measures - Sharing of Outcome Measures Reports - Access to Care - Outcome Measures – Referrals and Authorizations

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Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 2

Publication
6/15/2021

Topics covered in Set 2 include: - Behavior Technician Certification - Provider Certification Requirements - Participation Agreements - Restraints - Exclusions

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Comprehensive Changes to the Autism Care Demonstration

Autism Care Demonstration Policy Changes: Questions & Answers - Set 1

Publication
5/24/2021

Topics covered in Set 1 include: - Diagnostic requirements - Behavior Technicians in the School Change - Certain Community Settings

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Comprehensive Changes to the Autism Care Demonstration

ABA Maximum Allowed Rates Effective May 1 2021

Publication
4/13/2021

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Applied Behavior Analysis Maximum Allowed Amounts | Comprehensive Changes to the Autism Care Demonstration

ABA Maximum Allowed Rates Effective August 1, 2021

Publication
4/13/2021

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Download Letter to Beneficiaries

Publication
6/24/2020

This message replaces guidance issued on March 31. It explains actions military pharmacies are taking to keep services and visits safe during the COVID-19 pandemic, and it outlines your pharmacy options as a TRICARE beneficiary.

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Coronavirus | COVID Pharmacy Guidance | TRICARE Health Program

Communication to ABA Providers Regarding Continued Temporary Authorization to Utilize Telehealth for CPT Code 97156 During the COVID-19 National Emergency

Publication
6/3/2020

TRICARE is announcing the continuation of the temporary exception to policy regarding the use of synchronous telehealth (TH) capabilities (both audio and video) for Applied Behavior Analysis (ABA) Family Adaptive Behavior Treatment Guidance services specifically during this COVID-19 pandemic.

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Benefits Eligibility for 32 USC 502(f) Missions

Publication
4/14/2020

A chart outlining the various Benefits Eligibility for 32 USC 502(f) Missions

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Decision Memorandum on TRICARE Implementation of the "Families First Coronavirus Response Act"

Publication
4/7/2020

The Families First Coronavirus Response Act, Public Law 116-127, Division F, Section 6006(a), limits TRICARE authority to impose copayment or other cost-sharing for novel coronavirus (COVID-19) testing and related provider visits that result in orders for or administration of Food and Drug Administration (FDA) approved, cleared, or authorized diagnostic products. In order for the Defense Health Agency (DHA) to implement, the Assistant Secretary of Defense for Health Affairs (ASD(HA)) must acknowledge the self-executing authority of the statute and direct the Director, DHA, or designee, to issue guidance implementing the statutory provisions.

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TRICARE Health Program | Coronavirus

Pharmacy Guidance for Market MTFs

Publication
3/31/2020

Message to Pharmacy Beneficiaries regarding military pharmacy services during the COVID-19 pandemic.

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Coronavirus | Pharmacy Division | TRICARE Health Program

Tiered Telehealth Health Care Support for COVID-19

Publication
3/31/2020

This memorandum establishes guidance for the use of Telehealth (TH) Information Technology (IT) tools in support of the clinical care required for patients across the spectrum of COVID-19 illness

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Policy Exception for Telehealth Use for ABA during COVID-19 Pandemic

Publication
3/30/2020

Communication to ABA Providers Regarding Temporary Authorization to Utilize Telehealth for CPT Code 97156 During the COVID-19 National Emergency

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