TRICARE covers the non-surgical treatment of gender dysphoria when provided by a TRICARE-authorized provider. Non-active duty beneficiaries do not need a referral or preauthorization for outpatient, office-based, mental/behavioral health visits.
Effective July 1, 2022, treatment team conferences (CPT 99366, 99367, 99368) are also reimbursable under the TRICARE benefit.
Gender affirming hormone therapy for adults or adolescent beneficiaries is covered when criteria outlined in the most current version of the Endocrine Society Clinical Practice Guidelines for Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons are met and there are no contraindications to gender-affirming hormone therapy to receive endocrine therapy.
All services and supplies related to surgical treatment for gender dysphoria, including but not limited to, mastectomy, oophorectomy, and orchiectomy, are excluded.
See TRICARE Policy Manual (TPM): 1.) TPM Chapter 7, Section 1.3 and TPM Chapter 7, Section 3.8 for more information.
