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Public Safety Alert

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last updated Oct. 14, 2020

 

Find Up-to-Date Information about COVID-19 for TRICARE Providers


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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 the new COVID-19 related CPT® code 99072? (“Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service[s], when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease”)

At this time, TRICARE does not reimburse CPT 99072. However, as with all new codes, TRICARE is reviewing this code to determine if it should be covered. The Defense Health Agency will notify us if they determine the code should be reimbursed under TRICARE. 

Find information on COVID-19 diagnostic and antibody testing codes in the 'Reimbursement" section of our coronavirus 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. 

To be considered for coverage, antibody tests must be rendered to diagnose and/or treat beneficiaries. Antibody tests are not a covered benefit when performed:

  • on asymptomatic patients;
  • to satisfy patient curiosity;
  • to determine a patient's ability to return to work or school;
  • to determine a donor’s ability to donate blood or plasma; and/or
  • as part of epidemiological research, surveillance studies or for other public health reason.

In vitro diagnostic tests using Reverse Transcription Polymerase Chain Reaction (RTPCR) for asymptomatic active duty service members may be considered for coverage. 

Find benefit and cost information on our coronavirus Benefits A–Z page. 

 

Extended Referrals and Authorizations

Health Net Federal Services, LLC (HNFS) extended certain outpatient referrals and authorizations 180 days due to the COVID-19 pandemic. Although we did not issue new approval letters, you may still view and print updated authorization details from our Authorization Status tool. Follow these simple steps:

  1. From the provider portal, click on “Authorization Status” in the Secure Tools box (log in required). 
  2. Search for the specific authorization. 
  3. If you click on the “View authorization letter” link and the service dates don’t match the new status details, scroll to the bottom of the page and click on the “Print” button instead. This will allow you to print the new dates.  

Whether you submit requests using CareAffiliate® or our Web Authorization Referral Form (WARF), you can use the Authorization Status tool to view authorization status and details. 
 

How do I make changes to referrals or authorizations? Many changes can be made online. Visit our Request a Change page for more information. Please do not contact referring military hospitals and clinics for authorization changes. These requests must come to HNFS.
 

How can my TRICARE patients view their authorization letters? Please direct your patients to view determination letters from HNFS online. Once on our site, they can log in to use our Authorization Status tool.

 

Convalescent Plasma Collection

COVID-19 convalescent plasma is the liquid part of blood collected from patients who have recovered from a COVID-19 infection. Antibodies present in convalescent plasma are proteins that help patients fight an active infection; in this case, SARS-CoV-2, the virus that causes COVID-19. 
 

What is the COVID-19 Convalescent Plasma Collection Program?
The Defense Health Agency (DHA) is leading an effort to collect up to 10,000 COVID-19 convalescent plasma (CCP) units by Sept. 30, 2020. Collected CCP will be available for treatment of COVID-positive patients in military hospitals that meet established criteria and in accordance with approved protocols. This effort is designed to increase operational readiness of our combat forces and will help our nation study the use of CCP as a treatment. 

How can I help?
You likely have patients you diagnosed or treated for COVID-19 who are now recovered and symptom free. If you are near one of the Armed Services Blood Program collection centers, on behalf of DHA, we ask you actively reach out to any TRICARE beneficiary you treated for COVID-19 and encourage these patients to donate to DHA’s Convalescent Plasma Program.
 

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 to affected countries:
View the CDC’s current travel notice and FAQs.

For travelers already in affected countries 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