CPT 27096 · SI Joint · Tricare
Sacroiliac Joint Injection (CPT) at Tricare.
How Tricare approaches CPT 27096 (Sacroiliac Joint Injection (CPT)) for prior-authorization review: at last review on 2024-09-19, the policy covers this code without prior authorization.
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Verification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Tricare policy of record for CPT 27096. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 6 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: TRICARE — Is It Covered? Epidural Injections / Pain Management benefit (medical-necessity standard)
See the full Tricare criteria.
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