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Policy Update: Behavioral Health Care (Article 9)

TRICARE Management Activity (TMA) provides TRICARE Prime beneficiaries with a uniform behavioral health care benefit worldwide.

The continuing policy allows beneficiaries to obtain the first eight outpatient visits per year without prior authorization. Additionally, TRICARE Prime enrollees do not need a referral
from their PCM.

The ninth and subsequent visits will require authorization from Humana Military Healthcare Services, Inc. before the beneficiary will be covered under TRICARE. Humana Military has partnered with ValueOptions to deliver the behavioral health care benefit in the TRICARE
South Region.

Here are a few other reminders about delivering behavioral health care to TRICARE Prime beneficiaries:

1. You can provide behavioral health care services to beneficiaries if you are a:

• Psychiatrist
• Clinical psychologist
• Certified psychiatric nurse specialist
• Clinical social worker
• Certified marriage and family therapist
• Pastoral counselor
• Mental health counselor