9 Clinical Trials ...........................................................................................................................................46 Dental Services .......................................................................................................................................47 Preparing the Mouth for Medical Treatments ......................................................................................47 Treatment of Accidental Injury .............................................................................................................47 Anesthesia and Hospital Charges for Dental Care..............................................................................47 Diabetes Equipment, Education, and Supplies .......................................................................................47 Diagnostic Services .................................................................................................................................48 Diagnostic Laboratory and Pathology Services...................................................................................48 Diagnostic Imaging Services and Electronic Diagnostic Tests............................................................48 Advanced Imaging Services ................................................................................................................48 Dialysis ....................................................................................................................................................49 Durable Medical Equipment (DME), Medical Devices, and Supplies..................................................49 Orthotics...............................................................................................................................................49 Prosthetics ...........................................................................................................................................49 Prosthetic Limbs & Orthotic Custom Fabricated Brace or Support .....................................................50 Medical and Surgical Supplies.............................................................................................................50 Blood and Blood Products ...................................................................................................................50 Emergency Care Services.......................................................................................................................50 Emergency Services............................................................................................................................51 Habilitative Services ................................................................................................................................52 Home Health Care Services....................................................................................................................52 Home Infusion Therapy ...........................................................................................................................52 Hospice Care...........................................................................................................................................52 Human Organ and Tissue Transplant (Bone Marrow / Stem Cell) Services, Cellular and Gene Therapy Services...................................................................................................................................................53 Prior Approval and Precertification ......................................................................................................54 Inpatient Services ....................................................................................................................................55 Inpatient Hospital Care ........................................................................................................................55 Inpatient Professional Services ...........................................................................................................56 Maternity and Reproductive Health Services ..........................................................................................56 Maternity Services ...............................................................................................................................56 Contraceptive Benefits.........................................................................................................................57 Sterilization Services............................................................................................................................57 Infertility Services.................................................................................................................................57 Mental Health and Substance Use Disorder Services ............................................................................58 Occupational Therapy .............................................................................................................................58 Office and Home Visits............................................................................................................................58 Orthotics ..................................................................................................................................................59 Outpatient Facility Services.....................................................................................................................59 Physical Therapy .....................................................................................................................................59 Preventive Care.......................................................................................................................................59 Preventive Care for Chronic Conditions (per IRS guidelines) .................................................................61 Prosthetics...............................................................................................................................................61 Pulmonary Therapy .................................................................................................................................61 Radiation Therapy ...................................................................................................................................61 Rehabilitation Services............................................................................................................................61 Respiratory Therapy ................................................................................................................................62 Skilled Nursing Facility ............................................................................................................................62 Smoking Cessation..................................................................................................................................62 Speech Therapy ......................................................................................................................................62 Surgery ....................................................................................................................................................62 Oral Surgery.........................................................................................................................................62 Reconstructive Surgery........................................................................................................................63 Temporomandibular Joint (TMJ) and Craniomandibular Joint Services .................................................63 Therapy Services.....................................................................................................................................63 Physical Medicine Therapy Services ...................................................................................................63