However, if a TRICARE Prime beneficiary does not receive a transfer for care outside the region if necessary, the fees are paid under the Point of Service (POS) option. For more information, see tricare.mil/medicareeligible. Non-participating TRICARE network non-providers may charge up to 115% of the CMAC. Before providing care, network providers must notify TRICARE patients if services are not covered. The recipient must agree in advance in writing to maintain and assume financial responsibility for the services not covered. The “Application for Non-Covered Services” form can be used to document services, data, estimated costs and other information. If the recipient does not sign an application form for uncovered services or equivalent, you are financially responsible for the cost of the uncovered services you provide. *ABA suppliers should not complete the PIF, but rather email a completed TRICARE Provider Group, regardless of the number of suppliers in the group. TRICARE network providers are required to comply with these long-term access standards for the supply of beneficiaries. Medicare Bonus: Physicians (MDs and DOs), chiropodists, oral surgeons, and optometrists who qualify for Medicare bonuses in Healthcare Shortage Areas (HPSA) may be eligible for a 10 percent bonus for claims filed with TRICARE.

The only mental health care providers who are eligible for HPSA bonuses are MDs and DOs. .