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COVID-19 Information for TRICARE Providers

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last updated July 12, 2021

 

TRICARE Benefits


Delta Variant/Vaccine Confidence

The Delta variant is rapidly spreading, especially in areas where vaccination rates are low. The Delta variant is a NEW REASON to get vaccinated! TRICARE covers age-appropriate vaccines in accordance with CDC guidelines. Prior authorization is not required. Visit our Benefits A–Z section for benefit details and updates. 

  • Vaccine confidence: Check out the Centers for Disease Control and Prevention's (CDC) Vaccinate with Confidence campaign to increase COVID-19 vaccine confidence and uptake.

  • Are you interested in becoming a COVID-19 vaccine provider? Find details, including the required CDC COVID-19 Vaccination Program Provider Agreement. Providers enrolled in the program must monitor and comply with CDC COVID-19 Vaccination Program requirements. 


Online Resources

 

Changes to Your Practice? Let Us Know!

Network providers are required to promptly notify us of any demographic updates (changes, additions, deletions) as they occur. This helps ensure beneficiaries seeking health care services and providers seeking to refer care are viewing the most current and accurate provider information.

We recognize your locations, contact information, telehealth capabilities, and/or accepting new patients status may have changed due to COVID-19 impacts. Please visit our online Network Provider Directory to confirm your individual listing is accurate. 

Most demographic updates can be made online. Learn more.
 

Telemedicine

Now, more than ever, it’s important we help beneficiaries connect with providers who can see them via virtual appointments.
 

What is TRICARE's telemedicine benefit?
TRICARE covers medically and psychologically necessary telehealth services. TRICARE policy guidelines and exclusions apply. See our Telemedicine Services page for details.
 

How is telemedicine billed?
Visit our Telemedicine Billing page for details. 
 

How can I help my patients locate a telemedicine provider?
We’ve recently updated our online Network Provider Directory to help those in their telemedicine provider search. Select “Telemedicine” to get started.
 

How do I get listed as a telemedicine provider in the network directory?
Use our updated TRICARE Provider Group Roster Template to let us know which providers in your practice offer video telemedicine services. If you use a different template, please indicate on it who offers telemedicine services.

While TRICARE is temporarily allowing for audio-only telehealth, at this time, directory search results will only include providers who offer video telemedicine services. As such, please only identify on your roster those providers who offer video telehealth.

You must be in the TRICARE West Region network to be listed in our directory. If you have multiple state licenses, list them separately (by row) on the roster. You do not need to resubmit past rosters.

 

Billing Code Updates

Does TRICARE cover new COVID-19 related codes as they are introduced by CMS?
As with all new Current Procedural Terminology (CPT®) and Common Procedure Coding System (HCPCS) codes, TRICARE reviews them against policy to determine coverage. Our claims system is updated regularly to include added codes. Claims may be delayed to allow for appropriate code approval and system updates.

Find information on COVID-19 diagnostic and antibody testing on our Benefits A–Z page. 

 

COVID-19 Testing 

Does TRICARE cover COVID-19 testing?
TRICARE covers medically necessary and appropriate diagnostic and antibody (serology) testing. Beneficiaries suspected to have COVID-19 should be tested following Centers for Disease Control and Prevention (CDC) guidelines. COVID-19 diagnostic and antibody tests must meet Families First Coronavirus Response Act (FFCRA) criteria.

Diagnostic testing required prior to a procedure or admission may be considered medically necessary and appropriate. 

Please review our Benefits A–Z page. 

 

General 

What are the CDC recommendations for preventing the spread of COVID-19 and other viral illnesses?
Review CDC guidelines at www.cdc.gov/COVID19 and www.cdc.gov/coronavirus/2019-ncov/faq.html.
 

Where can I find current guidelines for health care providers?
Review the CDC’s guidance for health care professionals. Be sure to get a detailed travel history for patients who present with flu-like illness.
 

What recommendations should I give to patients who are concerned they may have COVID-19 or believe they have been in contact with someone with the virus?
Per the CDC,

  • Seek medical advice.
  • Call ahead before going to a doctor’s office or emergency room. 
    • Tell your doctor about recent travel and your symptoms. 
    • Some providers may offer telemedicine as an alternative to coming into the office. TRICARE covers medically-necessary telemedicine services when all criteria are met. Learn more on our Telemedicine Services page
    • If your primary doctor is not available, TRICARE beneficiaries can go to any TRICARE-authorized urgent care center or if necessary, an emergency department. 
    • TRICARE beneficiaries who need health advice can contact the Military Health System’s Nurse Advice Line 24/7. 
  • Avoid contact with others and do not travel while sick.
  • Contact your local public health department as soon as practical. 
  • Learn more at www.cdc.gov/coronavirus/2019-ncov/about/steps-when-sick.html


What can one do while sick to prevent the spread to others?
The best way to prevent illness from spreading is to avoid exposing others. Stay home except to get medical care, and separate yourself from other people and animals in your home. 


Travel

For those planning travel to abroad:
View the CDC’s current travel notice and FAQs.

For travelers already in where the virus may be present.
View the CDC’s current travel notice and FAQs.

For travelers returning from areas with the virus.
United States residents who travel to other countries where this outbreak has occurred may be screened upon re-entry to the U.S. 

 

 

 

Source: Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/index.html