Other Services
Chapter 8
Section 12.1
Wigs Or Hairpiece
Issue Date: April 19, 1983
Revision: C-52, September 20, 2019
1.0 HCPCS
Procedure Code
A9282
2.0 POLICY
2.1 Benefits
may be extended in accordance with the allowable charge, for one
wig (also known as cranial prosthesis) or hairpiece per beneficiary
(lifetime maximum) when the attending physician certifies that alopecia
has resulted from the treatment of a malignant disease and the beneficiary certifies
that a wig or hairpiece has not been obtained previously through
the U.S. Government (including the Department of Veterans Affairs/Veterans
Health Administration (DVA/VHA)).
2.2 Allowable
Charge. Effective January 1, 2011, the allowable charge may not
exceed the Calendar Year (CY) rate specified in
paragraph 2.3 per wig or hairpiece.
If the wig or hairpiece purchased by the beneficiary exceeds this
maximum amount, TRICARE shall reimburse only up to the allowable
amount. This amount shall be updated annually by using the Consumer
Price Index-Urban (CPI-U). The updated amount will be published
in this section.
2.3 The allowable charge per wig
or hairpiece may not exceed:
• $2,213 for 2016
• $2,213 for 2017
• $2,246 for 2018
• $2,295 for 2019
3.0 EXCLUSIONS
The wig /cranial prosthesis or hairpiece benefit
does not include coverage for the following:
3.1 Alopecia resulting from conditions
other than treatment of malignant disease.
3.2 Maintenance, supplies, or
replacement of the wig/cranial prosthesis or hairpiece. Statutory provisions
limit these items to one furnished at the expense of the Government
(i.e., prosthetic replacement provisions do not apply).
3.3 Hair transplants
or any other surgical procedure involving the attachment of hair
or a wig or hairpiece to the scalp.
3.4 Any diagnostic or therapeutic
method or supply intended to encourage hair regrowth.
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