Changes to Tricare East and West 2025

1. State Transition from Tricare East to Tricare West:
   • The following states will transition from Tricare East to Tricare West effective 1/1/2025:
     • Arkansas, Illinois, Louisiana, Oklahoma, Texas, and Wisconsin.
   • Claims for these states must be routed to Tricare West (PGBA) using payer ID 99726 for Dates of Service (DOS) on or after 1/1/2025.
   • For DOS prior to 1/1/2025, continue to use payer ID TREST.
2. Updates for Remaining Tricare East States:
   • For remaining states submitting to Tricare East:
     • Use payer ID TREST for DOS prior to 1/1/2025.
     • Use payer ID 99727 for DOS on or after 1/1/2025.
     • Starting 5/1/2025, all claims must be sent to payer ID 99727, regardless of DOS.
3. Provider Enrollment for Electronic Remittance Advice (ERA):
   • Action Required:
     • All providers in states transitioning to Tricare West must enroll under payer ID 99726.
     • Providers in states remaining with Tricare East must re-enroll under payer ID 99727.
   • New providers for both Tricare East and West are required to complete enrollment forms.
4. Enrollment for Claims Submission:
   • Providers credentialed with PGBA and with an Electronic Data Interchange (EDI) Provider Trading Partner Agreement on file do not need to take further action.

Please note that Tricare East has a new payer ID effective 1/1/2025. If your state remains in the Tricare East region, you will need to use the new payer ID for all claims with DOS on or after 1/1/2025 and if you currently receive ERAs from TREST, you will need to enroll for ERAs via the new Tricare East payer ID. For help on completing these steps, read Enroll to Receive Electronic Remittance Advice.