Limitations on TMJ Services Clause Samples

Limitations on TMJ Services a) TMJ benefits are subject to all the limitations, exclusions and other terms and conditions in this Contract. b) We will not pay for the replacement of any appliance furnished in whole or in part under this Contract or any other health plan which provides TMJ benefits. c) Benefits are limited to: those intra-oral services which would normally be provided by a Provider in relief of oral symptoms associated with TMJ and will not include those services which would normally be provided under medical care including, but not limited to, psychotherapy, special joint exams and x-rays, joint surgery and medications. d) Fixed appliances and restorations are excluded. Diagnostic procedures not otherwise covered under this Contract are excluded. e) Any procedure paid under any other category of benefits by this Contract is not covered as a TMJ benefit.‌