72 Hour Continuous Glucose Monitoring (CGM) Systems In Office

Abdominoplasty & Panniculectomy

Abnormal Vascular Lesion Removal

Ambulance: Land and Air Transportation

Autologous Cultured Chondrocytes

Back Surgical Procedures: Cervical & Thoracic Spinal Levels Inpatient & Outpatient

Back Surgical Procedures:  Lumbar Spinal Level

Inpatient & Outpatient

Back Surgical Procedure Vertebroplasty Inpatient & Outpatient

Blepharoplasty, Blepharoptosis Repair

Bone & Tendon Graft Substitutes & Adjuncts

Bone Growth Stimulator for the 5th Metatarsal

Botulinum Toxin Injections

Breast Reconstruction Post Mastectomy

Breast Reduction Mammoplasty

Carpal Tunnel Syndrome-Median Neuropathy Specialty Consult

Cellular Therapies

Chelation Therapy

Chronic Hip Pain-Osteoarthritis Specialty Consult

Chronic Knee Pain-Osteoarthritis or Meniscal Degeneration Specialty Consult

Cluster & Migraine Headache: Nonsurgical Management

Cologuard DNA Stool Testing

Complementary & Alternative Medicine

Contact Lenses

& Other Eyewear

Core Decompression of AVN of the Femoral Head

Cosmetic Surgery/Treatments

Cryoablation

Electrical Stimulation & Electromagnetic Therapy for the Treatment of Wounds

Erectile Dysfunction Treatments

Experimental

or Investigational

Eye Movement Desensitization &

Reprocessing (EMDR)

Fecal Microbiota Transplantation FMT

Femoroace-tabular Surgery for Hip Impingement Syndrome

Gastric Pacing & Gastric Electrical Stimulation

Gender Reassignment Services & Surgical Procedures

Genetic

Testing

Home Care Coverage Criteria

Home

Infusion

Hospice

Health

Services

Hyperbaric Oxygen Therapy

Hyperthermic Intraperitoneal Chemotherapy

Hysterectomy Surgical Procedures

Implantable Cardioverter Defibrillator  ICD Insertion Procedures

Implantable Hormone Pellet Replacement Therapy

Implantable Loop Recorder

Infuse Bone Graft Bmp-2 Procedure

Inpatient Admission Prior to Surgery

(Pre-op)

Intrastromal Corneal Ring Segments

Ivor Lewis Procedure

Knee Arthroscopy Surgery Precertification

Left Atrial Appendage (LAA) Closure to Reduce the Risk of Stroke

Low Back Pain (LBP) Consultation with Orthopedic or Neurosurgical Specialist

Lung Volume Reduction Surgery

MAZE

Procedure

Medicare Advantage Chiropractor

Medtronic IN.PACT Admiral Paclitaxel-coated PTA Balloon

Obesity Management, Surgical Approaches

Oral Appliances for the Treatment of Obstructive Sleep Apnea

Pancreas Transplant Alone (PTA) & Autologous Islet Cell Transplants

Peripheral Vascular

Stents

Physical, Occupational & Speech Therapy

Radiesse

Radiofrequency Ablation Pulmonary Tumor Debulking

Refractive Eye Surgery

Skin Substitutes, Chemical Peels, Dermabrasions, & other Skin Procedures

Telehealth

TMJ Benefit Review

Tilt Table Testing

Total Ankle Replacement

Total Disc Arthroplasty

Total Hip Replacement Surgical Precertification

Total Knee Replacement Surgical Precertification

Transcatheter Aortic Valve Replacement (TAVR)

Urinary Incontinence

Varicose Vein Treatments

Wearable Hearing Aids

Zika

Virus