Tricare South Region Application Form Page 3
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TRICARE
South Region Application
Social Workers
♦ Have an unrestricted license to practice at the highest level of independent practice in the state where
services are provided.
♦ Have a Master's degree in social work from a graduate school of social work accredited by the Council on
Social Work Education.
♦ Are participating Medicare providers or are Medicare providers accepting assignment.
Marriage and Family Therapists
♦ Have an unrestricted license to practice at the highest level of independent practice in the state where
services are provided.
♦ Have a Master's degree from an accredited educational institution in an appropriate behavioral science
field or mental health discipline.
TRICARE Certified Mental Health Counselors/Professional Counselors (No Physician Oversight)
♦ Have an unrestricted license to practice at the highest level of independent practice in the state where
services are provided.
♦ Possess a Master’s or higher level degree from a mental health counseling program of education and
training accredited for Mental Health Counseling or Clinical Mental Health Counseling by the Council for
Accreditation of Counseling and Related Education Programs (CACREP) and has passed the National
Counselor Examination (NCE); or
♦
Possess a Master’s or higher level degree from a mental health counseling program of education and
training accredited for Mental Health Counseling or Clinical Mental Health Counseling by the Council for
Accreditation of Counseling and Related Education Programs (CACREP) or from an educational
institution accredited by a Regional Accrediting Organization recognized by the Council for Higher
Education Accreditation and has passed the National Clinical Mental Health Counseling Examination
(NCMHCE).
Mental Health Counselors/Professional Counselors (SMHC; Physician Oversight Required)
♦ Have an unrestricted license to practice at the highest level of independent practice in the state where
services are provided.
♦ Have a Master's degree in mental health counseling or allied mental health field from a regionally
accredited institution.
♦ NOTE: Effective January 1, 2017, this category of provider will no longer be recognized by TRICARE.
Pastoral Counselors
♦ Have an unrestricted license to practice as a Pastoral Counselor in the state where services are provided.
In states that do not offer licensure, a Pastoral Counselor must be (or must meet all the requirements to
become) a fellow or diplomat member in the American Association of Pastoral Counselors (AAPC) as
determined by the AAPC.
♦ Have a Master's degree in mental health counseling or allied mental health field from a regionally
accredited institution.
Mental Health Counselors/Professional Counselors (Supervised) and Pastoral Counselors are required to have
physician referral prior to the initial patient evaluation, and on-going communication must continue with the
physician throughout the course of therapy in order to be reimbursed by TRICARE. This is a regulatory
TRICARE requirement that cannot be altered or waived.
PRR RECRUITING
Page 2 of 18
Revised 8/04; 10/04; 7/05; 9/05; 11/05; 1/06; 4/06; 6/06; 12/06; 3/07; 5/07;
Provider Application 08-15B
12/10; 7/11; 10/11; 11/11; 8/12; 10/12; 11/12; 02/13; 8/13; 2/14; 6/14; 01/15; 08/15
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