71. Telehealth. Consultations made by a Covered Person to a Physician. 72. Telemedicine. Refer to the Teladoc Services section of this SPD for more details.) 73. Temporomandibular Joint Disorder (TMJ) Services include: • Diagnostic services. • Surgical treatment • Non-surgical treatment (including intraoral devices or any other non-surgical method to alter occlusion and/or vertical dimension). Coverage does not include orthodontic services. 74. Therapy Services: Therapy must be ordered by a Physician and provided as part of the Covered Person’s treatment plan. Services include: • Occupational therapy by a Qualified occupational therapist (OT) or other Qualified Provider, if applicable. • Physical therapy by a Qualified physical therapist (PT) or other Qualified Provider, if applicable. • Respiratory therapy by a Qualified respiratory therapist (RT) or other Qualified Provider, if applicable. • Speech therapy necessary for the diagnosis and treatment of speech and language disorders that result in communication disabilities when performed by a Qualified speech therapist (ST) or other Qualified Provider, if applicable, including therapy for the treatment of disorders of speech, language, voice, communication, and auditory processing when such a disorder results from Injury, stroke, cancer, a Congenital Anomaly, or other types of communication disorders such as categorized language disorder, speech sound disorder, child-onset fluency disorder, and pragmatic communication disorder. 75. Tobacco Addiction: Preventive / Routine Care as required by applicable law and diagnoses, services, treatment, and supplies related to addiction to or dependency on nicotine. 76. Transplant Services. (Refer to the Transplant Benefits section of this SPD.) 77. Urgent Care Facility as shown in the Schedule of Benefits of this SPD. 78. Walk-In Retail Health Clinics: Charges associated with medical services provided at Walk-In Retail Health Clinics. 79. Wigs (Cranial Prostheses), Toupees, and Hairpieces for hair loss due to cancer treatment or alopecia related to a medical condition. -67- 7670-00-413597