Outpatient Mental Health and Substance Use Disorder Services Sample Clauses

Outpatient Mental Health and Substance Use Disorder Services. Benefits are covered for outpatient services provided in a Contracting Physician’s office or in other Contracting Provider facilities. Covered Services include the following: A. Diagnosis and treatment for Mental Illness and Emotional Disorders at Contracting Physician offices, other outpatient Contracting Provider medical offices and facilities, and in Qualified Partial Hospitalization Programs. B. Diagnosis and treatment for Substance Use Disorder, including detoxification and rehabilitation services as an outpatient in a covered alcohol or drug rehabilitation program or Qualified Partial Hospitalization Program designated by CareFirst BlueChoice. C. Other covered medical services and medical ancillary services for conditions related to Mental Illness, Emotional Disorders, and Substance Use Disorder. D. Office visits for medication management in connection with Mental Illness, Emotional Disorders, and Substance Use Disorder. E. Methadone maintenance treatment. F. Partial Hospitalization in a Qualified Partial Hospitalization Program. G. Electroconvulsive therapy.
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Related to Outpatient Mental Health and Substance Use Disorder Services

  • Behavioral Health Services – Mental Health and Substance Use Disorder Inpatient Hospital Unlimited days at a general hospital or a specialty hospital including withdrawal management (detoxification) per plan year. Residential Treatment Facility Unlimited days for residential mental health and substance use disorder services per plan year. Notification of admission may be required. 0% - After deductible Not Covered Outpatient or intermediate care services - See Covered Healthcare Services: Behavioral Health Section for details about partial hospital program, intensive outpatient program, adult intensive services, and child and family intensive treatment. Notification of services may be required. 0% - After deductible Not Covered Office visits - See Office Visits section below for Behavioral Health services provided by a PCP or specialist. Psychological Testing 0% - After deductible Not Covered Medication-assisted treatment - when rendered by a mental health or substance use disorder provider. 0% - After deductible Not Covered Methadone maintenance treatment. 0% - After deductible Not Covered Outpatient - Benefit is limited to 18 weeks or 36 visits (whichever occurs first) per covered episode. 0% - After deductible Not Covered

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services. This plan covers dental care for members until the last day of the month in which they turn nineteen (19). This plan covers services only if they meet all of the following requirements: • listed as a covered dental care service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered dental care service under this plan. • dentally necessary, consistent with our dental policies and related guidelines at the time the services are provided. • not listed in Exclusions section. • received while a member is enrolled in the plan. • consistent with applicable state or federal law. • services are provided by a network provider.

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