TRICARE-Authorized Provider

A TRICARE-authorized provider is any individual or institutional healthcare provider who meets TRICARE's standards for licensure, certification, and practice requirements. Authorization is a prerequisite for TRICARE to cover services rendered by a provider, whether they are in-network or out-of-network.

Types of TRICARE-authorized providers: • Individual providers: Physicians, nurse practitioners, psychologists, therapists, etc. • Institutional providers: Hospitals, skilled nursing facilities, ambulatory surgery centers • Suppliers: DME companies, home health agencies, laboratories

Authorization requirements: • Valid state license to practice in their profession • Meet TRICARE-specific credentialing standards • Comply with federal and state healthcare regulations • Maintain appropriate malpractice insurance • Not be excluded from federal healthcare programs

Network vs. authorized distinction: • All network providers are TRICARE-authorized • Not all TRICARE-authorized providers are in the network • Authorization means TRICARE can pay for services • Network status affects cost-sharing and billing practices

Before receiving care, verify that your provider is TRICARE-authorized to ensure your services will be covered. Your regional contractor can confirm a provider's authorization status.