Private Duty Nursing Services. This plan covers private duty nursing services, received in your home when ordered by a physician, and performed by a certified home healthcare agency. This plan covers these services when the patient requires continuous skilled nursing observation and intervention.
Private Duty Nursing Services. Must be performed by a certified home health care agency. 0% - After deductible 20% - After deductible
Private Duty Nursing Services. Private duty nursing services shall be provided by a person possessing a license and current registration from the NYS Education Department to practice as a registered professional nurse or licensed practical nurse. Private duty nursing services can be provided through an approved certified home health agency, a licensed home care agency, or a private Practitioner. The location of nursing services may be in the Enrollee's home or in the hospital. Private duty nursing services are covered only when determined by the attending physician to be medically necessary. Nursing services may be intermittent, part-time or continuous and provided in accordance with the ordering physicians, or certified nurse practitioner's written treatment plan.
Private Duty Nursing Services. Must be performed by a certified home health care agency. 0% - After deductible 20% - After deductible Radiation Therapy/Chemotherapy Services Outpatient 0% - After deductible 20% - After deductible In a physician’s office 0% - After deductible 20% - After deductible Respiratory Therapy Inpatient 0% - After deductible 20% - After deductible Outpatient 0% - After deductible 20% - After deductible Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible 20% - After deductible Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 0% - After deductible 20% - After deductible Surgery Services* Inpatient physician services 0% - After deductible 20% - After deductible Outpatient services - includes physician services and outpatient hospital or ambulatory surgical center facility services. 0% - After deductible 20% - After deductible In a physician’s office $20 20% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Telemedicine Services When rendered by our designated telemedicine provider. $40 Not Covered When rendered by a network provider other than our designated telemedicine provider. See the covered healthcare service being provided for theamount you pay See the covered healthcare service being provided for the amount you pay Tests, Labs, Imaging and X-rays - Diagnostic Outpatient, in a physician’s office, urgent care center or free-standing laboratory: Major diagnostic imaging and testing* including but not limited to: MRI, MRA, CAT scans, CTA scans, PET scans, nuclear medicine and cardiac imaging. 0% - After deductible 20% - After deductible Sleep studies.* 0% - After deductible 20% - After deductible Diagnostic imaging and tests, other than major diagnostic imaging and testing services noted above. $100 20% - After deductible Lab and pathology services. $50 20% - After deductible Diagnostic colorectal services - (Including, but not limited to, fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, and barium enema. See Prevention and Early Detection Services for preventive colorectal services.) 0% - After deductible 20% - After deductible Lyme disease diagnosis and treatment 0% - After deductible 20% - After deductible Urgent Care Urgent care services $150 The level of ...
Private Duty Nursing Services. 1. Your Plan pays for Private Duty Nursing Services when You are an Inpatient and when the nurse is not related to You by blood, marriage or adoption.
Private Duty Nursing Services. Private duty nursing services provided by a person possessing a license and current registration from the NYS Education Department to practice as a registered professional nurse or licensed practical nurse. Private duty nursing services can be provided through an approved certified home health agency, a licensed home care agency, or a private Practitioner. The location of nursing services may be in the Enrollee's home or in the hospital. Private duty nursing services are covered when determined by the attending physician to be medically necessary. Nursing services may be intermittent, part-time or continuous and provided in accordance with the ordering physician, registered physician assistant or certified nurse practitioner's written treatment plan. Dental Services (optional benefit outside of NYC) Dental care includes preventive, prophylactic and other routine dental care, services, supplies and dental prosthetics required to alleviate a serious health condition, including one which affects employability. Dental surgery performed in an ambulatory or inpatient setting is the responsibility of the Contractor whether dental services are a covered plan benefit, or not. Inpatient claims and referred ambulatory claims for dental services provided in an inpatient or outpatient hospital setting for surgery, anesthesiology, x-rays, etc. are the responsibility of the Contractor. In these situations, the professional services of the dentist are covered by Medicaid fee-for-service. The Contractor should set up procedures to prior approve dental services provided in inpatient and ambulatory settings. Medicaid Advantage Contract APPENDIX K State 2006 As described in Sections 10.9 and 10.18 of this Agreement. Enrollees may self-refer to Article 28 clinics operated by academic dental centers to obtain covered dental services. If Contractor's Benefit Package excludes dental services:
Private Duty Nursing Services. 1. Coverage is available to You for Private Duty Nursing Services as shown in the Schedule of Benefits when performed on an Outpatient basis and when the nurse is not related to You by blood, marriage or adoption.
Private Duty Nursing Services. Must be performed by a certified home health care agency. 0% - After deductible 20% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Radiation Therapy/Chemotherapy Services Outpatient 0% - After deductible 20% - After deductible In a physician’s office 0% - After deductible 20% - After deductible Respiratory Therapy Inpatient 0% - After deductible 20% - After deductible Outpatient 0% - After deductible 20% - After deductible Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible 20% - After deductible Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 20% - After deductible 40% - After deductible
Private Duty Nursing Services. For MMC Program Only
Private Duty Nursing Services. A. Private Duty Nursing Hourly Rate
