Outpatient psychotherapy that is medically or psychologically necessary to treat a covered mental health disorder is a covered benefit. This includes any combination of individual, family, collateral, or group sessions. Outpatient psychotherapy is also known as outpatient mental health care or outpatient therapy.
- Active duty service members (ADSMs) must have a referral from their primary care provider for all civilian mental health services, except for services authorized under Military OneSource, prior to receiving services from a TRICARE-authorized provider.
- TRICARE Prime beneficiaries (excluding ADSMs) do not require an approval from Health Net Federal Services, LLC (HNFS) when seeing a network provider. TRICARE Prime beneficiaries must have an approval from HNFS to see a non-network provider unless they choose to use their Point of Service option.
- TRICARE Select beneficiaries do not require an approval from HNFS.
Also see family therapy.
Outpatient mental health therapy visits with a supervised licensed pastoral counselor, supervised licensed professional counselor or supervised mental health counselor, must be referred or ordered and supervised by a physician (MD or DO). Please document this information in your clinical record and note on your 1500 claim form this documentation is on file.
- Certified marriage and family therapists must sign a participation agreement and are responsible for submitting all claims on behalf of the beneficiary.