Therapeutics

Select System

Noncovered

Services/Items

Treatment of Varicose Veins of Lower Extremity

Posterior Tibial Nerve Stimulation (PTNS)

Sacral Neuro-modulation

 Frequency of Hemodialysis Services

Chiropractic Services

Osteopathic Manipulative Treatment

Strapping

Therapy & Rehabilitation Services

Therapy Services billed by Physicians/Nonphysician Practitioners

Biofeedback

Psychiatric Inpatient Hospitalization

Psychiatric Partial Hospitalization Program

Psychological & Neuropsychological Tests

Transcranial Magnetic Stimulation for Major Depressive Disorder

Respiratory Therapeutic Services

Intensity Modulated Radiation Therapy (IMRT)

Proton Beam Radiotherapy

Radiation Therapy for T1 Basal Cell & Squamous Cell Carcinomas of the Skin

Laser Treatment Psoriasis

Routine

Foot Care

Wound

Care

 Emergency

Non-Emergency Ground Ambulance Services

Hyperbaric Oxygen Therapy

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