41 Coverage is provided for the treatment of autism spectrum disorders. Treatment is limited to services prescribed by your Physician in accordance with a treatment plan. Autism spectrum disorder means a neurological condition, including Asperger's syndrome and autism, as defined in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. Any exclusion or limitation in this Booklet in conflict with the coverage described in this provision will not apply . Coverage for autism spectrum disorders will not be subject to dollar limits, Deductibles, Copayment or Coinsurance provisions that are less favorable than the dollar limits, Deductibles, Copayments or Coinsurance provisions that apply to physical illness under your Plan. Behavioral Health Services Please see “Mental Health and Substance Use Disorder Services” later in this section. Biomarker Testing Services This Plan provides coverage for Medically Necessary Biomarker Testing when ordered by a qualified health care Provider operating within the Provider’s scope of practice for the purpose of diagnosis, treatment, appropriate management, or ongoing monitoring of a Member’s disease or condition when the test is sufficiently supported by medical and scientific evidence. Biomarker Testing may require prior authorization depending on the type of test. Member may be financially responsible for charges/costs related to Biomarker Testing in whole or in part if the service and/or setting is not found to be Medically Necessary. Cardiac Rehabilitation Please see “Therapy Services” later in this section. Cellular Services Your Plan includes benefits for certain cellular services, when Anthem approves the benefits in advance through Precertification. See the section “ Human Organ and Tissue Transplant (Bone Marrow / Stem Cell), Cellular Services” for additional details. Chemotherapy Please see “Therapy Services” later in this section. Chronic Pain Management Services Evidence based health care products and services intended to relieve chronic pain that has lasted for at least three (3) months are covered under this Plan. This includes: • Prescription drugs; • Physical Therapy; • Occupational Therapy; • Chiropractic care; • Osteopathic manipulative treatment; and • Athletic Trainer Services. See the sections “Athletic Trainer Services”, “Therapy Services” and “Prescription Drug Benefits at a Retail or Home Delivery (Mail Order) Pharmacy” for further details on the benefits for these services. As used in this section “Chronic pain" means pain that:
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