Common use of Professional Provider Services Clause in Contracts

Professional Provider Services. a. Except as limited, the following are covered: (1) Surgery and anesthesia services to include coverage for the administration of general anesthesia for dental care provided to the following covered persons: (a) A child five (5) years of age and under (b) A person who is severely disabled (c) A person who has a medical or behavioral condition that requires hospitalization or general anesthesia when dental care is provided (2) Treatment of fractures and dislocations. (3) Biopsies and aspirations. (4) Endoscopic (scope) procedures. (5) Maternity services (including the obstetrical and delivery expenses of the birth mother of a child adopted within 90 days of birth of such child). (6) Medical (non-surgical) services for Inpatients in a Hospital or Medical Care Facility. (See 4.b for details of this benefit.) (7) Diagnostic radiology services and Imaging studies. (8) Diagnostic laboratory services. (9) Radiation therapy. (10) Chemotherapy, other than High-Dose Chemotherapy, for malignant conditions. (See 4.c for details of the standard chemotherapy benefit and the Special Situations section for High-Dose Chemotherapy with Hematopoietic Support benefits.) (11) Diagnostic radio isotope studies. (12) Electroencephalograms (EEGs) and electrocardiograms (EKGs).