Physician services include the full range of preventive care services, primary care medical services and physician specialty services. All services must be medically necessary and appropriate for the treatment of a specific diagnosis as needed for the prevention, diagnostic, therapeutic care and treatment of a specific condition. Physician services are performed at physician's offices, patient's homes, clinics and skilled nursing facilities. Technical services performed in a physician's office are considered part of the professional services delivered in an ambulatory setting unless designated as a separate service.
Current Service Limitations: Twelve (12) visits per year for adults, unlimited for children under the age of 21.
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