Due to a low response from Autism Corporate Service Providers (ACSP) in submitting a new participation agreement to remain TRICARE-authorized, the Defense Health Agency (DHA) has issued an extension through September 15, 2021.
Per TRICARE Operations Manual (TOM), ACSPs (including sole providers) must enter into a participation agreement. These providers practicing prior to July 1, 2021, must re-sign all of their participation agreements no later than September 15, 2021 or risk terminating their TRICARE- authorized status.
To fulfill the new policy requirement, ACSPs should submit a new certification before September 15, 2021. See TOM, Chapter 18, Section 4, paragraph 8.3 for more information on this requirement.
NOTE: Individual Behavior Analysts, Assistant Behavior Analysts, and Behavior Technicians working under tiered delivery models do not need to complete the ACSP application.
Per TOM Chapter 18, Section 4, paragraph 8.2.1, all ABA practitioners must obtain a National Provider Identifier (NPI) number (all claims must have the rendering provider’s name and NPI for processing). Claims will deny for any ABA providers (including Assistant Behavior Analysts and Behavior Technicians) who did not possess an NPI prior to August 1, 2021. Visit self-service to add or update an NPI.
DHA also requires all ABA providers to submit claims and receive payments electronically (location-specific) through Electronic Media Claims (EMC) and Electronic Fund Transfers (EFT).
