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Information for Providers

Being a TRICARE provider means that you're treating America's heroes—the people making sacrifices to keep America strong and safe. On behalf of the Department of Defense, the men and women of our Armed Forces and their families, as well as our retired families, we want thank you for your desire to become a TRICARE provider. Becoming a TRICARE provider brings with it a higher volume of patients as network providers are placed on the worldwide referral list for all TRICARE beneficiaries.

What's New?

2016 Applied Behavior Analysis Maximum Allowable Amount Announced

On Dec. 1, 2015, TRICARE announced the 2016 rates for applied behavior analysis to take effect in Spring 2016. 

New Online Training Location

We are consolidating the education and training opportunities from multiple learning management systems into one system—the Joint Knowlege Online Learning Content Managment System. >>Learn More

E-Prescribing Now Available at Most Military Pharmacies

The Electronic Prescribing (eRx) initiative is a Defense Health Agency, Pharmacy Operations Division project that allows civilian providers to electronically transmit prescriptions to military pharmacies. >>Learn More

Managed Care Support Contractors

Each TRICARE region has its own managed care support contractor (MCSC) who is responsible for administering the TRICARE program in each region. The MCSCs establish the provider networks and conduct provider education.

If you're already a TRICARE-Authorized ProviderAn authorized provider is any individual, institution/organization, or supplier that is licensed by a state, accredited by national organization, or meets other standards of the medical community, and is certified to provide benefits under TRICARE. There are two types of TRICARE-authorized providers: Network and Non-Network. or if you want to become a TRICARE-authorized provider,  call your MCSC or visit the website, listed below. 

 Region  Managed Care Support Contractor
North
  • Health Net Federal Services
  • www.hnfs.com 
  • 1-877-TRICARE (1-877-874-2273)
South
West
Overseas

Claims Processors

PGBA

PGBA is the claims processor for the North, South and West regions. For assistance, please contact the Provider EDI & XPressClaim Help Desk:

Wisconsin Physicians Service

Wisconsin Physicans Serivce (WPS) is the claims processor for TRICARE For Life claims in the United States and U.S. Territories. For assistance please contact WPS Customer Service:

Overseas Claims

Claims for covered medical services delivered outside the United States and U.S. Territories (TFL claims are filed with WPS as noted above) are filed with the TRICARE Overseas Program claims processor. >>View Overseas Claims Submission Guidelines

Last Updated 1/13/2016