IMPORTANT: Prior authorization information
Prior authorization is required for laboratory developed tests except for CF testing. CF testing, when part of the Newborn screening panel, is handled under the global maternity authorization. For the quickest processing to approval for any prior authorization, providers should submit the request via Humana Military’s secure self-service for providers portal. (Learn how to submit a new LDT request.) Providers may choose to fax the completed LDT request form to 1-877-548-1547. For all requests-
Given the complexity of risk assessment and test interpretation, as well as the importance of adequate medical management, genetic counseling is very valuable to any individual receiving a LDT. Genetic counseling may only be provided by TRICARE-authorized providers and must precede the actual LDT.
Beneficiaries are responsible for the appropriate copay/cost-share on lab claims processed with the approved authorization on file according to their benefit plan. Claims for genetic testing submitted without an approved authorization will be denied. Other Health Insurance (OHI) rules apply.
For more information on the TRICARE policy, refer to TRICARE Operations Manual: Chapter 18, Section 18. TRICARE policies can be found at tricare.mil under TRICARE Manuals.