With the beginning of the new TRICARE fiscal year on Oct. 1, the behavioral health care outpatient visit count is renewed for all TRICARE beneficiaries except active duty service members (ADSMs).* As of Oct. 1, you are once again eligible for eight outpatient behavioral health care visits to a network provider without prior authorization or a referral from your primary care manager (PCM) or Humana Military Healthcare Services, Inc.’s (Humana Military’s) behavioral health care partner, ValueOptions.
After the first eight visits, prior authorization is required. A physician referral is not required for these visits, but authorization is required to establish medical necessity.
There are certain providers, however, for which a physician referral and supervision are always required, even for the first eight visits. These include licensed professional counselors, licensed mental health counselors and pastoral counselors.
For more information on behavioral health care and prior authorization requirements, visit the “
Behavioral Health” section on the beneficiary portal.
