How to Submit a Superbill to TRICARE for Therapy Reimbursement

TRICARE Out-of-Network Process

TRICARE covers mental health services provided by OON therapists as long as the provider is TRICARE-authorized. Therapists do not need to be in-network but must be authorized by TRICARE. Members submit OON claims through their TRICARE regional contractor's portal (Humana Military for East, Health Net Federal Services for West, or International SOS for Overseas). Paper claims can also be mailed to the regional contractor's OON claims address.

Common Denial Reasons

• ✗Provider is not TRICARE-authorized — therapists must complete TRICARE authorization before seeing beneficiaries
• ✗Claim submitted to the wrong regional contractor for the member's duty station
• ✗CPT code not covered under TRICARE's mental health benefit (e.g., group therapy codes require prior auth)
• ✗Superbill lacks required military member's sponsor ID (SSN) or DoD beneficiary ID

Tips for Getting Reimbursed by TRICARE

• ✓Therapists must apply for TRICARE authorization at tricare.mil — it is a separate process from standard credentialing
• ✓Ensure your superbill includes the sponsor's SSN or DoD ID number, which is required for all TRICARE claims
• ✓TRICARE Prime members may have no OON mental health benefits — verify plan type before starting care
• ✓TRICARE Select and TRICARE For Life have stronger OON benefits with lower copayments