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Primary Care Providers (PCP or PCM) – The Primary Care Provider includes Primary Care Managers (PCM) under the TRICARE Prime or TRICARE Prime Remote for Active Duty Family Member programs; and Primary Care Physician (PCP) under the TRICARE Standard program; and describes a Military Treatment Facility (MTF) provider or team of providers or a network provider to whom a beneficiary is assigned for primary care services at the time of enrollment in TRICARE Prime.
The EIA Supervisor must review the Behavior Plan and EIA Progress Reports with the PCP, PCM, or the beneficiary’s Specialized Autism Spectrum Disorder(ASD) Provider before requesting authorization of services from the MCSC’s case manager. The physician must concur with the plan.
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Specialized ASD Provider
A TRICARE authorized provider who is:
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A physician board-certified or board-eligible in behavioral developmental pediatrics, neurodevelopmental pediatrics, pediatric neurology or child psychiatry;
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A physician or Ph.D. educated psychologist working primarily with children with:
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One or more years of supervised fellowship training that included 40 or more hours of clinical experience in comprehensive evaluations for ASD as evidenced by the name, location and dates of the qualifying fellowship; or
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One or more years of supervised on-the-job training that included the performance of ASD diagnostic evaluations an average of twice each month as evidenced by the position, location and dates of the qualifying on-the-job training.
A Specialized ASD Provider may diagnose ASD through evaluation and testing.
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