Beneficiaries Using
TRICARE Standard and TRICARE Extra, TRICARE Reserve Select, or TRICARE Retired
Reserve
Beneficiaries using TRICARE Standard and TRICARE Extra, TRS, or TRICARE Retired Reserve (TRR) generally do not need referrals and can receive their first eight outpatient visits without prior authorization to diagnose and/ or treat behavioral health components of an otherwise diagnosed medical or psychological condition. Services provided by a licensed or certified mental health counselor or pastoral counselor require physician referral and supervision.
Upon the first visit, providers may check eligibility, if registered, at www.triwest.com/provider or call 1-888-TRIWEST (1-888-874-9378) for eligibility verification or other questions. It is important to note that the first eight visits are per beneficiary, not per provider. Ask the beneficiary
if he or she has received previous behavioral health care.
After the first eight self-referred outpatient visits, prior authorization is required. Servicing providers must submit authorization requests online at www.triwest.com/provider, after registering, or complete and fax a Preauthorization for Outpatient Treatment Request form to 1-866-269-5892. The request will be reviewed to determine whether continuing care meets
InterQual criteria. No additional sessions are authorized until the treatment request is reviewed.
Beneficiaries using TRICARE Standard and TRICARE Extra, TRS, or TRICARE Retired Reserve (TRR) generally do not need referrals and can receive their first eight outpatient visits without prior authorization to diagnose and/ or treat behavioral health components of an otherwise diagnosed medical or psychological condition. Services provided by a licensed or certified mental health counselor or pastoral counselor require physician referral and supervision.
Upon the first visit, providers may check eligibility, if registered, at www.triwest.com/provider or call 1-888-TRIWEST (1-888-874-9378) for eligibility verification or other questions. It is important to note that the first eight visits are per beneficiary, not per provider. Ask the beneficiary
if he or she has received previous behavioral health care.
After the first eight self-referred outpatient visits, prior authorization is required. Servicing providers must submit authorization requests online at www.triwest.com/provider, after registering, or complete and fax a Preauthorization for Outpatient Treatment Request form to 1-866-269-5892. The request will be reviewed to determine whether continuing care meets
InterQual criteria. No additional sessions are authorized until the treatment request is reviewed.
