DME
- Breast Pumps MP.053.MH
- Breast Reconstruction Procedures and External Breast Protheses MP.046.MH
- Compression Stockings and Garments MP.015.MH
- Continuous Home Pulse Oximetry MP.006.MH
- Continuous Passive Motion Devices MP.024.MH
- Cough Assist Devices MP.047.MH
- Home Apnea Monitoring MP.008.MH
- Home Oxygen Therapy MP.130.MH
- Hospital Beds and Accessories MP.061.MH
- Knee Scooters (Select Only) MP.145.MH
- Lower Limb Orthotics and Shoes MP.132.MH
- Oral Appliances for Obstructive Sleep Apnea MP.063.MH
- Sleep Apnea Treatment, PAP Devices MP.023.MH
- Speech Generating Devices MP.040.MH
- Surgical Dressings Wound Care Supplies MP.011.MH
- Transcutaneous Electrical Nerve Stimulators MP.094.MH
Home Health
- Light Therapy in the Home, UV B and Skin Conditions MP.041.MH
- Home PT/INR Monitoring MP.068.MH
- Home Sleep Study MP.069.MH
Other Services
- E-visits MP.075.MH
- Management of Unlisted HCPCS and CPT Codes MP.056.MH
- Skin Substitutes MP.083.MH
- COVID-19 Telemedicine MP.065.MH
- Air Ambulance MP.203.MH (Formerly PA.200.MH)
Outpatient Services
- Chelation Therapy MP.019.MH
- Chiropractic Services (Ages 13 and Over) MP.111.MH
- CTA of the Chest MP.044.MH
- CT Colonography MP.055.MH
- Digital Breast Tomosynthesis MP.201.MH
- External Counterpulsation Therapy MP.107.MH
- Eye-Anterior Segment Optical Coherence Tomography MP.072.MH
- Heart Disease Lifestyle Modification Program MP.059.MH
- High-Resolution Anoscopy MP.114.MH
- Hyperbaric Oxygen Therapy MP.084.MH
- Incontinence, Biofeedback MP.123.MH
- Intensity-Modulated Radiation Therapy MP.034.MH
- Intravascular Ultrasound for Coronary Vessels MP.091.MH
- Iontophoresis for Musculoskeletal Conditions MP.036.MH
- Laryngeal Injections for Vocal Cord Augmentation MP.112.MH
- Low Dose CT Scan, Lung Cancer Screening MP.131.MH
- Magnetic Resonance Spectroscopy MP.127.MH
- Magnetoencephalography MP.078.MH
- Medical Nutrition Therapy MP.048.MH
- Nerve Block, Paravertebral, Facet Joint, and SI Injections MP.090.MH
- Nerve Conduction Velocity Studies MP.043.MH
- Non Vascular Extremity Ultrasound MP.092.MH
- Ocular Photoscreening MP.143.MH
- PIOL and ACIOL MP.009.MH
- Routine Foot Care MP.010.MH
- Stereotactic Radiosurgery and Body Radiation Therapy MP.060.MH
- Thyroid Nodule Molecular Testing MP.128.MH
- Trigger Point and Transforaminal Epidural Injections MP.098.MH
- Vision Therapy MP.104.MH
- Visually Evoked Response Test MP.049.MH
Outpatient / Surgical
- Posterior Tibial Nerve Stimulators MP.129.MH
- Prophylactic Mastectomy MP.101.MH
- Radiofrequency Ablation (Thermal) for Chronic Spinal Pain MP.093.MH
- Temporomandibular Joint Disorders MP.016.MH
- Varicose Veins MP.066.MH
Pharmacy (Medical Benefit)
Surgical Procedures
- Blepharoplasty MP.074.MH
- Deep Brain and Dorsal Column (Spinal Cord) Stimulators MP.108.MH
- Endometrial Ablation MP.089.MH
- Endovascular Repair - Stent for AAA MP.103.MH
- Glaucoma, Invasive Procedures MP.124.MH
- Intraoperative Neurophysiological Testing MP.087.MH
- Oral Maxillofacial MP.138.MH
- Prophylactic Bilateral Salpingo-Oophorectomy MP.076.MH
- Sacral Nerve Stimulators MP.110.MH
- Septoplasty-Rhinoplasty MP.038.MH
- Vagus Nerve Stimulators MP.025.MH
Testing: Genetic/Lab
- Bladder Cancer Biomarker Tests MP.052.MH
- Cell-Free DNA Test MP.126.MH
- Cologuard- Colonic Fecal Testing MP.150.MH
- Colorectal Cancer, Mutation Test for Treatment MP.088.MH
- CYP2D6 Gene Analysis MP.119.MH
- Genetic Testing: Cystic Fibrosis MP.116.MH
- Genetic Testing: Inherited Colorectal Cancers MP.042.MH
- Genetic Testing: Lung Cancer MP.115.MH
- Genetic Testing: Topographic Genotyping MP.027.MH