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Mental Health Counselor Provider Requirements

TRICARE Certified Mental Health Counselor

Under TRICARE, a TRICARE certified mental health counselor (TCMHC) is an independent provider who does not require referral and oversight by a physician in order to receive reimbursement for service to a beneficiary.

Provider Requirements

An individual must meet the following requirements to become a TCMHC:

1. Pass the National Clinical Mental Health Counseling Examination (NCMHCE);

and

2. Possess a master's or higher-level degree from:

  • a Council for Accreditation of Counseling & Related Educational Programs (CACREP)-accredited program for mental health counseling or clinical mental health counseling; or
  • from a program that is accredited by any of the following:*
    • Accrediting Commission for Community and Junior Colleges-Western Association of Schools and Colleges Higher Learning Commission
    • Middle States Commission on Higher Education
    • New England Association of Schools and Colleges Commission on Institutions of Higher Education
    • Southern Association of Colleges and Schools Commission on Colleges
    • WASC Senior College and University Commission
    • Accrediting Bureau of Health Education Schools
    • Accrediting Commission of Career Schools and Colleges
    • Accrediting Council for Independent Colleges and Schools
    • Distance Education Accreditation Commission

and

3. Complete a minimum of two years post master's degree supervised mental health counseling, including at least 3,000 hours of supervised clinical practice and 100 hours of face-to-face supervision. The supervisor must meet the specific requirements in TRICARE Policy Manual, Chapter 11, Section 3.11.


*Per the National Defense Authorization Act (NDAA) for Fiscal Year 2016, Section 716, TRICARE expanded the list of entities which are considered eligible to accredit education for authorizing TCMHCs. This expanded list is effective during a transition period of November 25, 2015 through December 31, 2020. Please review TRICARE Policy Manual, Chapter 11, Section 3.11, Paragraph 2.1.3 for details. Not all entities on this expanded list currently accredit mental health counseling programs. Therefore, we recommend you verify with the education institution that issued or will issue your mental health counseling degree its program is accredited by one of the listed entities or by CACREP.

How to Submit Proof of Completion

Network Providers Non-Network Providers
Submit to HNFS:

Fax: 1-844-836-5818
Mail: HNFS
        Attn: Provider Network Management
        PO Box 9410
        Virginia Beach, VA 23450-9410
Submit to PGBA, LLC:

Fax: 1-844-730-1373
Mail: TRICARE West – Provider Data Management
        PO Box 202106
        Florence, SC 29502-2106

 

Supervised Mental Health Counselor

Under TRICARE, a supervised mental health counselor (SMHC) is an individual who does not meet the TCMHC requirements listed above. 

Provider Requirements

An individual must meet the following requirements to become an SMHC:

1. Possess a minimum of a master’s degree in mental health counseling or allied mental health field from a regionally accredited institution; 

and 

2. Have two years of post-master’s experience which includes 3,000 hours of clinical work and 100 hours of face-to-face supervision;

and 

3. Be licensed or certified to practice as a mental health counselor by the jurisdiction where practicing.

The SMHC shall be reimbursed when the following criteria are met:

  • The TRICARE beneficiary is referred for therapy by a physician; 
  • a physician is providing ongoing oversight and supervision of the therapy being provided; and 
  • the SMHC certifies on each claim for reimbursement that written communication has been made or will be made to the referring physician of the results of the treatment. (Note: This communication must be made at the end of the treatment, or more frequently, as required by the referring physician).

Additional Information