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Medical Coverage policies are developed to communicate Samaritan Health Plan decisions about coverage and benefits for various medical services. Each coverage policy contains a description of the medical and behavioral health service, as well as the coverage determination, product application, coding considerations and requirements for prior authorization. Determinations are made after careful consideration of evidence, product or service factors, regulatory/compliance, operational issues, community standards, service availability, and other pertinent factors.

Applied Behavioral Analysis
CANS for Use in Wraparound
Computer Assisted Surgical Navigational Procedure
Drug Testing in the Outpatient Setting
Evaluation of New and Existing Technologies
Gender Dysphoria Medical Necessity Criteria
Genetic Testing
Hearing Aids
LUXTURNA
Nusinersen (UM)
Ocrelizumab (Ocrevus)
Proprietary Laboratory Analyses
Psychiatric Respite Admission
Psychiatric Sub-Acute Admission
Synagis (Palivizumab)
Wireless Gastrointestinal MonitoringSystem

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