The National Defense Authorization Act (NDAA) 2016, Section 725, has activated this pilot to determine the possible elimination of referrals for urgent care visits and improve access to immediate care from an Urgent Treatment Center rather than an Emergency Room. The urgent care visit can also be provided by a network physician’s office. This pilot program goes into effect May 23, 2016 and will continue until May 23, 2019.
Zika virus disease in the United States, 2015–2016 (as of February 3, 2016)
Humana Military has added spinal fusion and related procedures to the prior authorization required list effective January 18th, 2016. The code look up feature provides direction to create a prior authorization request by procedure code to assist you in your submission.
Effective October 1, 2015, (DHA) Department of Health Affairs for the TRICARE program, added personal incontinence supplies as a covered item for qualified beneficiaries.
Per TRICARE Policy Manual: Chapter 9, section 13.1 - incontinence briefs are now covered for Active Duty Family Members enrolled in the ECHO program age 3 and older. Active Duty Family Members under the age of 3 and military retirees and family members are not included. The incontinence supply for the qualified beneficiary is paid out of the member’s annual ECHO program allowance.
HCPC codes covered in this benefit are:
*Certificate of medical necessity is not required for incontinence supplies ordered for the qualified ECHO beneficiary
**All services and supplies provided under the ECHO program require prior authorization
The Humana Military team is committed to assisting both providers and beneficiaries after the recent incident in Chattanooga. We have collected resources on coping with tragedy and loss to assist in your crisis counseling. Please feel free to share with your TRICARE beneficiaries and the Chattanooga community as needed. We hope this information proves helpful in treating your patients.
TRICARE now covers breast pumps, breast pump supplies, and breastfeeding counseling as mandated by Section 706 of the Fiscal Year 2015 National Defense Authorization Act. The addition of this benefit is retroactive to December 19, 2014.
Going forward- Civilian Providers can request the equipment and supplies with a valid Certificate of Medical Necessity (CMN) or a physician order to the DME provider for qualifying TRICARE beneficiaries. Lactation counseling is covered as well, when available at facilities, clinics, or physician offices.
J & B Medical Supply
Pumping Essentials LLC
McKesson Patient Care Solutions
Breast pump specialty line
For breast pump orders
Phone: 844-727-6667 (Providers)
Phone: 855-406-PUMP (7867) (Beneficiaries)
Sunmed Medical Systems
Fax Orders: 800-715-5422
Recent changes to the No Government Pay list for TRICARE
Pediatric PCM information - Same day wellnesss and sick visits
When a child presents for a sick visit and is due for a preventive visit, you may complete a well-child assessment, in addition to rendering for the presenting problem.
TRICARE demonstration project for approved Laboratory Developed Tests (LDTs)
Update on approved genetic testing under the Laboratory Developed Tests (LDT) Demonstration Project. Two new tests have been added to the LDT Demonstration project by TRICARE.
TRICARE service center walk-in service ending
As more people use convenient internet and phone options for their customer service needs, TRICARE is phasing out walk-in service at 189 TRICARE Service Centers (TSCs) across the 50 United States as of April 1, 2014. The majority of TSCs are located at military hospitals and clinics.
Overseas TRICARE Service Centers will not be affected due to the unique nature of the beneficiary audiences. Beneficiaries can get more information about these changes and sign up for TSC e-mail updates at tricare.mil/TSC .