Therapeutics

Select System

Indicates Non-Covered Service

-Humana-

-Aetna-

Autologous Cellular Therapy for Certain Indications

-UHC-

Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell Transplantation

-Aetna-

Humana-

Transanal Radiofrequency Therapy as a Treatment of Fecal Incontinence

-FloridaBlue-

Therapeutic Phlebotomy

-Cigna-

-FloridaBlue-

 Unna

Boot

Electrical Stimulation for the Treatment of Arthritis

Suit Therapy

-Aetna-

Warming Therapy & Ultrasound Therapy for Wounds

-UHC-

-Aetna-

-Cigna-

-UHC-

Inpatient Treatment for Substance-Related & Addictive Disorder Treatment

-Maryland-

-UHC-

-UHC-

-United-

-FloridaBlue-

-Humana-

-Aetna-

-Cigna-

-Cigna-

-Humana-

-Anthem-

-Aetna-

-Anthem-

-Cigna-

-Humana-

-Medicare-

-FloridaBlue-

-Humana-

-FloridaBlue-

Adoptive Immunotherapy

-Cigna-

-FloridaBlue-

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

-Anthem-

Bronchial Thermoplasty

-Cigna-

-FloridaBlue-

Carotid Intima-Media Thickness Measurement 

-Cigna-

-FloridaBlue-

-Cigna-

-Cigna-

Custodial & Non-Skilled Services

-Cigna-

Exhaled Nitric Oxide & Exhaled Breath Condensate in the Management of Respiratory

Disorders

Headache & Occipital Neuralgia Treatment

-Cigna-

Low Level Laser Therapy (Cold Laser Therapy), High Power Laser Therapy

-Cigna-

High-Frequency Pulsed Electromagnetic Stimulation

-Aetna-

Hippotherapy

-Aetna-

Neutron Beam Radiotherapy

-Anthem-

-Cigna-

Rehabilitative Devices with Remote Monitoring

-Anthem-

Ultrasound Therapy for Wound Healing

-Humana-

 Virtual Reality-Assisted Therapy Systems

-Anthem-

420, 421, 422, 423, 424, 429, 430, 431, 432, 433, 434, 439, 440, 441, 442, 443, 444,, 449, 90875, 90876, 90901, 90912, 90913, 92507, 92508, 92520, 92526, 92606, 92609, 92630, 92633, 97010, 97012, 97014,97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036,, 97039, 97110, 97112, 97113, 97116, 97124, 97129, 97130, 97139, 97140, 97150,,97164, 97168, 97530, 97533, 97535, 97537, 97542, 97545, 97546, 97750, 97755,, 97760, 97761, 97763, 97799, G0129, G0283, S9152, V5362, V5363, V5364, 90889, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 0362T, 0373T, H0031, H0032, H2012, H2019, 912, 913, 915, 90867, 90868, 90869, K1002, 98940, 98941, 98942, 98943, 43647, 43648, 43881, 43882, 64590, 99183, G0277, , 32701, 61796, 61798, 63620, 77371, 77372, 77373, 77385, 77386, 77401, 77402, 77407, 77412, 77423, 77424, 77425, 77520, 77522, 77523, 77525, 77750, 77761, 77762, 77763, 77767, 77768, 77770, 77771, 77772, 77778, G0339, G0340, G0458, G6003, G6004, G6005, G6006, G6007, G6008, G6009, G6010, G6011, G6012, G6013, G6014, G6015, G6016, 420, 421, 422, 423, 424, 429, 430, 431, 432, 433, 434, 439, 440, 441, 442, 443, 444, 449, 92507, 92508, 92520, 92526, 92606, 92609, 92630, 92633, 97010, 97012, 97014, 97016, 97018, 97022, 97024, 97026, 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97129, 97130, 97139, 97140, 97150, 97164, 97168, 97530, 97533, 97535, 97537, 97542, 97545, 97546, 97750, 97755, 97760, 97761, 97763, 97799, G0129, G0283, S9152, V5362, V5363, V5364, , 95115, 95117, 95144, 95145, 95146, 95147, 95148, 95149, 95165,

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