28 Prosthetics See “Durable Medical Equipment (DME), Medical Devices, and Supplies.” Pulmonary Therapy See “Therapy Services.” Radiation Therapy See “Therapy Services.” Rehabilitation Services Benefits are based on the setting in which Covered Services are received. See “Inpatient Services” and “Therapy Services” for details on Benefit Maximums. Respiratory Therapy See “Therapy Services.” Skilled Nursing Facility See “Inpatient Services.” Speech Therapy See “Therapy Services.” Surgery Benefits are based on the setting in which Covered Services are received. Temporomandibular and Craniomandibular Joint Treatment Benefits are based on the setting in which Covered Services are received. Therapy Services Benefits are based on the setting in which Covered Services are received. Benefit Maximum(s): Benefit Maximum(s) are for In- and Out-of-Network visits combined, and for office and outpatient visits combined. • Physical and Occupational Therapy 40 visits per Benefit Period • Speech Therapy 20 visits per Benefit Period • Manipulation Therapy 12 visits per Benefit Period • Cardiac Rehabilitation 36 visits per Benefit Period • Pulmonary Rehabilitation 20 visits per Benefit Period