Military Health System

2.1  The contractor shall reimburse 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 shall 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, the contractor shall reimburse only up to the allowable amount. The Government will update this amount annually by using the Consumer Price Index-Urban (CPI-U). DHA will publish the updated amount in this section.

2.3  The allowable charge per wig or hairpiece may not exceed:

2.4  Effective for service dates on or after July 1, 2021, refer to the TRICARE Reimbursement Manual (TRM), Chapter 1, Section 11 for annual and periodic adjustments to these rates. The Government will not publish future pricing in this Section since the rates will be updated and made available at https://health.mil/Military-Health-Topics/Business-Support/Rates-and-Reimbursement/Durable-Medical-Equipment-Prosthetics-Orthotics-and-Supplies.

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.