Noncovered
Services/Items
Chiropractic Services
Outpatient Physical & Occupational Therapy Services
Outpatient Psychiatry & Psychology Services
Psychiatric Inpatient Hospitalization
Psychiatric Partial Hospitalization Program
Psychosocial Rehabilitation Services
Repetitive Transcranial Magnetic Stimulation (rTMS) in Adults with Treatment Resistant Major Depressive Disorder
Proton Beam Radiotherapy
Allergy Immunotherapy
Speech-Language Pathology
Stretta Procedure
Transcatheter Infusion
Therapy
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