Military/TRICARE

Phoenix, Arizona (TriWest Healthcare Alliance)

TRICARE West RegionBehavioral Health Contracting

TriWest Facility Credentialing & Network Participation

TRICARE West Region, managed by TriWest Healthcare Alliance as of January 1, 2025, serves military members, retirees, and families across the western United States. The program emphasizes accessible, quality healthcare for those who serve our nation.

Visit TRICARE West Website Provider Portal Enrollment Portal

Quick Facts

States Served

Members

4.9+ million beneficiaries

Market Share

N/A

Network

Over 195,000 network providers

TRICARE West serves approximately 4.9+ million beneficiaries across 26 states in the western United States.

Detailed Information

Everything you need to know about contracting with TRICARE West Region for behavioral health services

Behavioral Health

Coverage details & levels of care

Behavioral Health Coverage

TRICARE West provides comprehensive mental health and substance abuse benefits for all levels of care including residential, PHP, IOP, and outpatient services. Facilities must be TRICARE-certified and meet specific accreditation requirements.

Behavioral Health Manager

Integrated within TriWest (no carve-out)

Covered Levels of Care

All treatment settings accepted by TRICARE West

Inpatient Psychiatric

Residential Treatment Center (RTC) - up to age 20 for dependents

Partial Hospitalization Program (PHP)

Intensive Outpatient Program (IOP)

Outpatient Mental Health

Substance Use Disorder Treatment (all levels)

Detoxification Services

Opioid Treatment Programs (OTP)

Program Strengths

What sets TRICARE West apart

Direct access to mental health care without referral for most beneficiaries

Specialized PTSD treatment programs

Comprehensive substance use disorder care at all levels

Family therapy and counseling

Autism spectrum disorder services

Crisis intervention services

Telehealth mental health services with full parity

Virtual PHP and IOP programs covered

Facility Certification Requirements

Required credentials for network participation

Current state license as treatment facility
TJC, CARF, or COA accreditation required for facilities
NPI number (facility and rendering providers)
Professional liability insurance
CAQH registration recommended for providers
Background screening
Medicare participation status documentation
Peer Review Organization (PRO) Agreement required for facilities

Prior Authorization

Required

Medical Necessity Criteria

InterQual Level of Care Criteria

Reimbursement Notes

Payment and billing information

Medicare-based reimbursement rates
Per diem rates for residential and PHP services
No cost sharing for active duty
Electronic payment available via EFT
Timely filing within one year
Telehealth reimbursement parity for all services
Claims processor: PGBA (Palmetto Government Benefits)

Network Opportunities

Network Adequacy & Expansion

Current network needs and priority areas for facility contracting with TRICARE West

Current Network Needs

Seeking facilities in rural/frontier areas and near military installations

Priority Areas for Network Expansion

High-demand service areas and locations

Rural and frontier areas

Specialized PTSD programs

Adolescent residential treatment

Native American/Alaska Native culturally competent care

Facilities near military installations

Virtual PHP/IOP providers

Trauma-informed care specialists

Military culture competent providers

Available Incentives

Enhanced network opportunities for facilities near military bases

Coverage Area

Geographic Coverage

TRICARE West Region provides coverage in 26 states across the United States

States with Coverage

26 states nationwide

Alaska

Arizona

Arkansas

California

Colorado

Hawaii

Idaho

Illinois

Iowa

Kansas

Louisiana

Minnesota

Missouri

Montana

Nebraska

Nevada

New Mexico

North Dakota

Oklahoma

Oregon

South Dakota

Texas

Utah

Washington

Wisconsin

Wyoming

Corporate Headquarters

Phoenix, Arizona (TriWest Healthcare Alliance)

Expert Contracting Support

Ready to Contract with TRICARE West?

Our team specializes in TRICARE West Region contracting for behavioral health facilities. We'll help you secure competitive rates and streamline your credentialing process.

Complete CAQH profile optimization

Strategic rate negotiation

Application preparation & submission

Persistent follow-up until contracted

Get Started Today Compare All Payers

15-40% Higher Rates

Achieve significantly better reimbursement through expert negotiation

Faster Contracting

Reduce credentialing timeline from months to weeks

Full Compliance

CAQH, state licensing, and accreditation guidance

Dedicated Support

Your personal contracting specialist throughout the process

500+

Facilities Contracted

Days Avg. Timeline

98%

Success Rate

States Covered