Beginning in January 2016, TRICARE beneficiaries with a diagnoses and referral for surgical treatment of femoroacetabular impingment, according to the U.S. Department of Defense.
Here are six key points:
1. Femoroacetabular impingment, or FAI, is a hip condition where the bones in the hip are abnormally shaped and do not fit together perfectly, causing the bones to rub against each other and cause damage to the joint.
2. Symptoms of this condition include pain in the hip or groin area, which limits or hinders mobility.
3. The FAI surgery is the first treatment evaluated and approved under the 2015 National Defense Authorization Act's provisional coverage program. This allows TRICARE to provide coverage for emerging treatments and technologies.
4. While the costs will vary by plan, they will be lower for those using network providers.
5. The surgery must be pre-authorized by the beneficiary's regional contractor, which lets providers present additional information for review by TRICARE and its contract partners.
6. There is no retroactive pre-authorization or coverage prior to Jan. 1, 2016.