Worker's Compensation
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Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Chelation Therapy - Dimercaprol (BAL)
Peripheral Artery Disease of the Lower Extremities Angiography, Screening & Exercise Rehabilitation
Allogeneic Hematopoietic Cell Transplantation
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Autologous & Allogeneic Pancreatic Islet Cell Transplantation
Donor Lymphocyte Infusion for Hematologic Malignancies after Allogeneic Hematopoietic Progenitor Cell Transplantation
Hematopoietic Stem Cell Transplantation for Genetic Diseases & Aplastic Anemias
Hematopoietic Stem Cell Transplantation for Germ Cell Tumors
Hematopoietic Stem Cell Transplantation for Hodgkin Disease & non-Hodgkin Lymphoma
Hematopoietic Stem Cell Transplantation for Multiple Myeloma & Other Plasma
Cell Dyscrasias
Hematopoietic Stem Cell Transplantation for Pediatric Solid Tumors
Hematopoietic Stem Cell Transplantation for Select Leukemias & Myelodysplastic Syndrome
Hematopoietic Stem Cell Transplantation for Thalassemia Major & Sickle Cell Disease
Stem Cell Transplantation: Blood Cancers
Thymus Tissue Transplantation
Umbilical Cord Blood Progenitor Cell Collection, Storage and Transplantation
Autologous Cellular Therapy for Certain Indications
Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation
Assessing Your Weight
Healthy Weight & Finding a Balance
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Chronic Kidney Disease Basic Education
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& Mental Health
Preventing Diabetic Complications & Managing Sick Days
Education & Diabetic Management During
Ramadan
Diabetic Pharmacological Management During Ramadan
Risk Stratification of Patients with T2 DM Who Wish to Fast During Ramadan
Risk Stratification of Patients with T2 DM Who Wish to Fast During Ramadan
Structured Pre-Ramadan Education to Raise Awareness Risks of Diabetes & Fasting
Extended release opioids
Healthy Eating for a Healthy Weight
Healthy Weight
Healthy Weight & Finding a Balance
Hospitalization for the Initiation of a Ketogenic Diet
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Tips for Parents-Ideas to Help Children Maintain a Healthy Weight
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Chronic Pain Programs
Preparing for Natural Disasters for People with Diabetes
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Adult Preventive Health Guidelines
Quick Screen to Identify Excessive Drinking
Chronic
Vertigo Treatment
Dysphagia/Swallowing Diagnosis & Therapy
Treatment of Tinnitus
Ultrasonic
Surgery for Meniere's Syndrome
Vestibular Rehabilitation
Voice
Therapy
Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Chelation Therapy - Dimercaprl (BAL)
Fecal Bacteriotherapy
Fecal Microbiota Transplantation FMT
Gastric Pacing, Enterra Therapy
Levator Syndrome Treatment
Transanal Radiofrequency Therapy as a Treatment of Fecal Incontinence
Frequency of Hemodialysis Services
Out-of-Network Outpatient Dialysis at In-Network Level of Benefits
Percutaneous Tibial Nerve Stimulation
Peritoneal Dialysis
Sacral
Nerve Stimulation
Allogenic Hematopoietic Cell Transplants for Sickle Cell Anemia & beta-Thalassemia
Chelation Therapy - Edetate Calcium Disodium (Calcium EDTA)
Chelation Therapy - Deferoxamine Mesylate (Desferal)
Chelation Therapy - Dimercaprol (BAL)
COVID-19 Convalescent Plasma
Low Density Lipoprotein (LDL) Apheresis
Plasmapheresis
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Acute Inpatient Rehabilitation
Axial/Spinal Decompression Therapy/Mechanical Traction (Provided in a Clinic Setting)
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Constraint-Induced Therapy
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Mechanical Stretching Devices for Joint Stiffness & Contracture
Osteopathic Manipulative Treatment
Occupational Therapy
Therapy & Rehabilitation Services
Physical Therapy
Physical Therapy & Occupational Therapy
Range of Motion Testing
Strapping
Treatment of Autism Spectrum Disorders
Unna
Boot
Electrical Stimulation for the Treatment of Arthritis
Suit Therapy
Warming Therapy & Ultrasound Therapy for Wounds
Epilepsy Surgery
Ketogenic Diet for Treatment of Intractable Seizures
Monoclonal Antibody Therapies for Migraine Prevention
Neurological & Brain Injury Life Skills & Rehabilitation
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Inpatient Adult Psychiatry-
Treatment Days 1-6
Inpatient Adult Psychiatry-
Treatment Days 7-13
Inpatient Treatment for Substance-Related & Addictive Disorder Treatment
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Intensive Outpatient Program Substance-Related & Addictive Disorder Treatment
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Low Intensity Residential Clinical Services for Substance-Related & Addictive Disorder Treatment
Adult Major Depressive Disorder (MDD): Suicide Risk Assessment (CMS161v10)
Methadone Treatment for Opiate Addiction
Observation Status Adult Psychiatry
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Outpatient Treatment of Substance-Related & Addictive
Disorder Treatment
Partial Hospitalization Program Substance-Related & Addictive
Disorder Treatment
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Phototherapy for Psychiatric Disorders
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Psychotherapy
Psychotherapy for Crisis
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Substance-Related & Addictive
Disorder Treatment
Substance-Related & Addictive
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Substance-Related & Addictive
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Substance-Related Outpatient Withdrawal (Detoxification) with Extended On-Site Monitoring
Substance-Related Outpatient Withdrawal (Detoxification) without Extended On-Site Monitoring
Targeted Case Management
Transcranial Magnetic Stimulation (TMS)
Diagnostic
Aerosol or Vapor Inhalation
Electrical Stimulators - Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular
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Obstructive
Sleep Apnea Treatment
Phrenic (Diaphragmatic) Nerve Stimulation
Pulmonary Rehabilitation
Respiratory Therapeutic Services
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(APBI)
Accelerated Breast Irradiation & Brachytherapy Boost After Breast-Conserving Surgery for Early-Stage Breast Cancer
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Brachytherapy
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Chemotherapy Observation or Inpatient Hospitalization
Cranial Stereotactic Radiosurgery (SRS) & Cranial Stereotactic Radiotherapy (SRT)
Electric Tumor Treatment
Field Therapy
Endobronchial Brachytherapy
Fractionation, Image-Guidance, & Special Services
High-Dose Rate Temporary Prostate Brachytherapy
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Hyperthermia (superficial external, interstitial) for Cancer Therapy
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Hyperthermic intraperitoneal chemotherapy (HIPEC)
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Intensity-Modulated Radiation Therapy (IMRT): Abdomen & Pelvis
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Intensity-Modulated Radiotherapy: Central Nervous System Tumors
Intensity-Modulated Radiotherapy: Cancer of the Head & Neck or Thyroid
Intensity-Modulated Radiotherapy of the Prostate
Intraoperative Radiation
Therapy
Isolated Limb Perfusion/Infusion for Malignant Melanoma
Microwave Thermotherapy
Oncologic Applications of Photodynamic Therapy
Proton Beam Radiotherapy
(CNS & Axial Skeleton)
Proton Beam Radiotherapy ( Non CNS )
Proton & Neutron Beam Radiation Therapy
Radiation Therapy for T1 Basal Cell & Squamous Cell Carcinomas of the Skin
Radiation Therapy: Fractionation, Image-Guidance, & Special Services
Radioembol-ization for Primary & Metastatic Tumors of the Liver
Radio-frequency Tumor Ablation
Selective Internal Radiation Therapy (SIRT) for Primary & Secondary Hepatic Malignancy (Yttrium-90 -Microsphere Hepatic Brachytherapy)
Stereotactic Radiosurgery (SRS) & Stereotactic Body Radiation Therapy
(SBRT)
Stereotactic Radiosurgery (Intracranial)
Tumor Treatment Fields (TTF) Therapy for Glioblastoma
Whole Brain Radiotherapy (WBRT)
Actinic
Keratosis
Allergen Immunotherapy
Allergy
Testing
Eye
Allergy Testing: Patch Testing
Allergy Testing In Vivo (Skin Tests)
Allergy Treatments
-Humana-
Electrical Stimulation (ES) & Electromagn-etic Therapy for the Treatment of Wounds
EpiFix Wound Treatment
Lymphedema & Venous Stasis Ulcer Treatments
Complex Lymphedema Therapy (Complete Decongestive Therapy)
Lymphedema- Diagnosis & Treatment
Phototherapy & Photochemo-therapy (PUVA) for Skin Conditions
Targeted Phototherapy & Psoralen with Ultraviolet A for Vitiligo
Topical Photosensitizers used with PDT for Actinic Keratoses
& Certain Skin Cancers
Treatment of Decubitus Ulcers
Wound
Care
Allergy Immunotherapy
Ambulance Services-
Air & Water
Ambulance Services-
Non-emergency Ground
Ancillary Services for Pregnancy Complications
Aquatic
Therapy
Art Therapy
Brachytherapy
Cold Therapy Devices/Heating Devices/Combined Heat & Cold Therapy Devices
Donor Human Milk
Electric Stimulation for Pain, Swelling & Function in a Clinic Setting
Electrical Stimulators for Pain & Nausea/Vomiting
Electrical Stimulation for the Treatment of Pain & Muscle Rehabilitation
Equine-assisted Therapy for Behavioral Health
Eye Movement Desensitization &
Reprocessing (EMDR)
Home Health Aides
Home Phototherapy Devices for Neonatal Hyperbilirubinemia
Hydration Therapy
Hyperbaric & Topical Oxygen Therapies
Iontophoresis
Inpatient Subacute Care
Intestinal Rehabilitation Programs
Long Term Care Hospitals (LTCH)
Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy
Manipulative Therapy
Medical
Maggots
Medicinal Leech Therapy
Neonatal Level of Care
Non-pharmacologic Treatments for Chronic
Vertigo
Outpatient Skilled Nursing & Skilled Rehabilitation Services
Observation Room Services
Observation vs. Admission Criteria Making for the Treatment of Emergency Room Conditions
Outpatient Use of Arixtra, Direct Thrombin Inhibitors, & Low Molecular Weight Heparin (LMWH)
Parenteral Drug Administration & In-Office Dispensing of Medications
Pet
Therapy
Platelet-Derived Growth Factors for Wound Healing
Pritikin Program
Private Duty Nursing in the Home Setting
Skilled Home Health Care Nursing Services
Skilled Nursing Facility Services
Special Treatment Procedure & Special Physics Consult
Transcatheter Infusion
Therapy
Adoptive Immunotherapy
Auditory & Sensory Integration Training Therapy (AIT)
Autologous Cell-Based Therapy for Cardiac and Peripheral Arterial Disease
Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])
Biomagnetic Therapy
Bronchial Thermoplasty
Carotid Intima-Media Thickness Measurement
Custodial & Non-Skilled Services
Exhaled Nitric Oxide & Exhaled Breath Condensate in the Management of Respiratory
Disorders
Headache & Occipital Neuralgia Treatment
Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy
High-Frequency Pulsed Electromagnetic Stimulation
Hippotherapy
Neutron Beam Radiotherapy
Rehabilitative Devices with Remote Monitoring
Ultrasound Therapy for Wound Healing
Virtual Reality-Assisted Therapy Systems
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