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Join the Network-Provider Eligibility for Network Participation
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Before completing the Application for Individual Provider Status, please review the following summary of minimum criteria for consideration as a network provider. Providers must be credentialed through the ValueOptions application process prior to receiving TRICARE referrals.
The provider network criteria are as follows:
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Psychiatrists/Addictionologists
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- Must have an unrestricted license as an MD or DO in the state where services are provided; or have received special State licensure if employed by a college or university.
- Must have one of the following: Board Certification in psychiatry; evidence of having completed a residency program in psychiatry; or American Society of Addiction Medicine (ASAM) certification.
- Have a current Drug Enforcement Administration (DEA) Certificate.
- Submit an Education Council for Foreign Medical Graduates (ECFMG) Certificate, if a graduate of a foreign medical school.
- Are participating Medicare providers.
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Family Practice / Pediatric MD/DO – Behavioral Health Criteria
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- Must meet the licensure, DEA and ECFMG criteria for Psychiatrists/Addictionologists
- Board Certification in Family Practice or Pediatrics, with sub-certification in Developmental Behavioral Pediatrics or Neurodevelopmental Disabilities, OR evidence of having completed a residency program in Family Practice or Pediatrics and a fellowship in Developmental Behavioral Pediatrics or Neurodevelopmental Pediatrics or Behavioral Medicine.
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Psychologists |
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- Have an unrestricted license to practice as a clinical psychologist in the state where services are provided.
- Have a doctoral degree in psychology (PhD, EdD, PsyD) from an accredited college or university.
- Are participating Medicare providers.
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Social Workers |
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- Have an unrestricted licensed to practice at the highest level of independent practice in the state where services are provided.
- Have a Master's degree in social work from a graduate school of social work accredited by the Council on Social Work Education.
- Are participating Medicare providers.
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Marriage and Family Therapists |
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- Have unrestricted licenses to practice at the highest level of independent practice in the state where services are provided.
- Have a Master's degree from an accredited educational institution from an appropriate behavioral science field or mental health discipline.
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Mental Health Counselors/Other Clinicians |
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- Have an unrestricted license to practice at the highest level of independent practice in the state where services are provided.
- Have a Master's degree in mental health counseling or allied mental health field from a regionally accredited institution.
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Pastoral Counselors |
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- Have an unrestricted license to practice as a Pastoral Counselor in the state where services are provided. In states that do not offer licensure, a Pastoral Counselor must be (or must meet all the requirements to become) a fellow or diplomate member in the American Association of Pastoral Counselors (AAPC) as determined by the AAPC.
- Have a Master's degree in mental health counseling or allied mental health field from a regionally accredited institution.
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| Mental Health Counselors/Other Clinicians and Pastoral Counselors are required to have physician referral prior to the initial patient evaluation, and physician oversight must continue throughout the course of therapy in order to be reimbursed by TRICARE. This is a regulatory TRICARE requirement that cannot be altered or waived. |
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Psychiatric Nurses |
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- Have an unrestricted licensed to practice at the highest level of independent practice in the state where services are provided.
- Must have a Master's degree in psychiatric nursing from an accredited college or university in a program recognized by the American Nursing Association (ANA).
- Must be certified by the American Nurses Credentialing Center (ANCC).
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Nurse Practitioners |
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- Must have unrestricted licenses to practice as a Nurse Practitioner with Psychiatric Nursing as the specialty in the state where services are provided.
- Must have a Master's degree from an accredited college or university in a program recognized by the American Nursing Association (ANA).
- Are participating Medicare Providers
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Professional Liability Coverage
(Applicant’s name must be included on the policy face sheet) |
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| Psychiatrists and Other Prescribing Practitioners |
$1,000,000.00 per individual episode;
$3,000,000.00 aggregate. |
| All Other Clinicians |
$1,000,000.00 per individual episode;
$1,000,000.00 aggregate. |
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