Do I need a referral for mental health care under TRICARE?

TRICARE has specific referral rules for mental health:

First 8 Outpatient Visits (All Plans)

• No referral required
• No authorization required
• Per beneficiary per year
• Applies to outpatient care only

After 8 Visits

• TRICARE Prime: Referral from PCM required
• TRICARE Select: No referral needed
• Authorization may be required

Exceptions (No Referral Needed)

• Crisis situations
• Emergency mental health
• Inpatient admission (crisis)
• Substance use evaluations

Prime Referral Process

• Contact PCM for referral
• PCM may refer to MTF or civilian provider
• Referral good for specified visits
• Can request extension if needed

Finding Providers

• Use TRICARE provider directory
• Filter for mental health specialty
• Check if accepting new patients
• Verify network status