Residential Treatment Center
Care at a residential treatment center (RTC) is a covered benefit for children and adolescents up to age 21, when medically or psychologically necessary. Admission to an RTC primarily for substance use disorder (SUD) rehabilitation is not a covered benefit. To qualify for RTC admission, a TRICARE-authorized independent mental health provider shall recommend admission.
Geographically distant family therapy (GDFT) allows family members and legal guardians who live 250 miles or more from the RTC facility to take part in weekly therapy sessions via telephone. One onsite session is preferred monthly. Generally, TRICARE reimburses RTC care at an all-inclusive per diem rate, however, GDFT is considered outside the all-inclusive RTC rate. Family therapists should note this type of therapy session with “GDFT” in the remarks block of the claim form for reimbursement.
Provider and family applications must be completed before review will occur. Prior authorization is required for all beneficiaries. When requesting a prior authorization for continued RTC care or discharge review, a completed Residential Treatment Center (RTC) Concurrent/Discharge Review form must be submitted along with a request for timely processing.
Additional information can be found on our Residential Treatment Center Care under TRICARE guide.
See also Hospitalization for Mental Health.