Abatacept (Orencia^®) 
Alefacept Injection Amevive 
Belimumab (Benlysta)
Botulinum Toxin Injection
Capsaicin (Qutenza^®)
Chemotherapy For Malignant Disease
Denosumab (Prolia^TM, XGEVA^TM)
Immune Globulin Therapy
Infliximab (Remicade)
Intravenous Antiobiotic Therapy for Lyme Disease
Ipilimumab (Yervoy)
Natalizumab Tysabri
Pulmonary Hypertension, Drug Management
Repository Corticotropin (H.P. Acthar Gel)
Respiratory Syncytial Virus Prophylaxis
Rituximab for the Treatment of Rheumatoid Arthritis
Tocilizumab (Actemra)
Treatment of Hereditary Angioedema
Treatment for Severe Primary IGF-1 Deficiency
Ustekinumab (Stelara)
Xolair (Omalizumab)

Acoustic Cardiography
Adoptive Immunotherapy
Allergy Immunotherapy (Desensitization)
Allergy Testing
Ambulance and Medical Transport Services
Ambulatory Event Monitors
Analysis of Proteomic Patterns for Early Detection of Cancer
Anesthesia Services
Antiprothrombin Antibody Testing
Aqueous Shunts and Devices for Glaucoma
Assays of Genetic Expression to Determine Prognosis of Breast Cancer
Baroreflex Stimulation Devices
Biofeedback
Bioimpedance Devices for Detection of Lymphedema
BRAF Gene Mutation Testing to Select Melanoma Patients for BRAF Inhibitor Therapy
Cardiac Hemodynamic Monitoring in the Outpatient Setting
Cardiovascular Disease Risk Tests
Carotid Intimal-Medial Thickness Study
Chelation Therapy
Chemoembolization of the Hepatic Artery, Transcatheter Approach
Clinical Trial Services For Life Threatening Conditions
Common Genetic Variants to Predict Risk of Nonfamilial Breast Cancer
Complementary and Alternative Medicine
Computerized 2-Lead Resting Electrocardiogram Multifunction Cardiogram
Convection-Enhanced Delivery of Therapeutic Agents to the Brain
Corneal Collagen Cross-linking
Cytochrome p450 Genotyping
Detection of Circulating Tumor Cells
Developmental Delay Screening and Testing Guidelines
DNA Based Testing for Adolescent Idiopathic Scoliosis
Diagnosis and Treatment of Chronic Cerebrospinal Venous Insufficiency in Multiple Sclerosis
Dynamic Posturography
Electrocardiographic Body Surface Mapping
Electrodiagnostic Studies
Electrogastrography, Cutaneous
Electromagnetic Navigation Bronchoscopy
Electrostimulation and Electromagnetic Therapy for Chronic Wounds
Enhanced External Counterpulsation (EECP)
Enteral Nutrition
Epidermal Growth Factor Receptor (EGFR) Mutation Analysis for Patients with Non-Small Cell Lung Cancer (NSCLC)
Esophageal pH Monitoring
E-visits (Online Medical Evaluation)
Exhaled Nitric Oxide Measurement
Extracorporeal Photopheresis
Fecal Analysis in the Diagnosis of Intestinal Dysbiosis
Gait Analysis
Gene-Based Tests for Screening, Detection, and/or Management of Prostate Cancer
Gene Expression Testing to Predict Coronary Artery Disease
Genetic Testing for Alpha-1 Antitrypsin Deficiency
Genetic Testing for Breast and Ovarian Cancer
Genetic Testing for Colon Cancer
Genetic Testing for Cutaneous Malignant Melanoma
Genetic Testing for Familial Alzheimer's Disease
Genetic Testing for FMR1 Mutations Including Fragile X Syndrome
Genetic Testing for Helicobacter pylori Treatment
Genetic Testing for Hereditary Hemochromatosis
Genetic Testing for Long QT Syndrome
Genetic Testing for Non-Malignant Inherited Disorders
Genetic Testing for Predisposition to Inherited Hypertrophic Cardiomyopathy
Genetic Testing for Rett Syndrome
Genetic Testing for Tamoxifen Treatment
Growth Factors in Wound Healing
Hyperbaric Oxygen Pressurization
Hyperhidrosis, Treatment of
Hyperthermia Therapy
Identification of Microorganisms Using Nucleic Acid Probes
Idiopathic Environmental Intolerance (i.e. Multiple Chemical Sensitivities)
Immune Cell Function Assay
Ingestible pH and Pressure Capsule
Injectable Clostridial Collagenase for Fibroproliferative Disorders
Insulin Therapy, Chronic Intermittent Intravenous (CIIIT)
Intracellular Micronutrient Analysis
Intradialytic Parenteral Nutrition
Intravenous Anesthetics for the Treatment of Chronic Pain
In Vitro Chemoresistance and Chemosensitivity Assays
JAK2 and MPL Mutations in Myeloproliferative Neoplasms
Laboratory Testing to Allow Area Under the Curve (AUC) Targeted 5-Fluorouracil (5-FU) Dosing for Patients Administered 5-FU for Cancer
Laboratory Tests for Heart Transplant Rejection
Magnetic Esophageal Ring to Treat Gastroesophageal Reflux Disease (GERD)
Measurement of Serum Antibodies to Infliximab
Melanoma Vaccines
Microarray based Gene Expression Testing for Cancers of Unknown Primary
Multianalyte Assays for Predicting Risk of Type 2 Diabetes
Multianalyte Assays for the Evaluation and Monitoring of Patients with Liver Disease
Multigene Expression Assay for Predicting Recurrence in Colon Cancer
Mutation Analysis in Fine Needle Aspirates of the Thyroid
Nerve Fiber Density Testing
Non-Contact Ultrasound Treatment for Wounds
Non-BRCA Breast Cancer Risk Assessment (Onco Vue)
Non Pharmacologic Treatment of Rosacea
NOTCH3 Genotyping for Diagnosis of CADASIL
Observation Room Services
Occipital Nerve Stimulation
Optical Diagnostic Devices for Evaluating Skin Lesions Suspected of Malignancy
PathFinder TG Molecular Testing
Pelvic Floor Stimulation as a Treatment of Urinary Incontinence
Pharmacogenetic Testing for Warfarin Dose
Private Duty Nursing Services
Progenitor Cell Therapy for the Treatment of Damaged Myocardium Due to Ischemia
Prolotherapy
Proteomics Based Testing for the Evaluation of Ovarian (Adnexal) Masses
Quantitative Assay for Measurement of HER2 Total Protein Expression and HER2 Dimers
Serum Holo-Transcobalamin as a Marker of Vitamin B12 Status
Signal Averaged ECG
Skilled Nursing Facility Care
Skilled Nursing Services
Sleep Apnea: Diagnosis and Medical Management
Systems Pathology for Predicting Risk of Recurrence in Prostate Cancer
T - Wave Alternans
Telemedicine
Total Parenteral Nutrition
Urinary Tumor Markers for Bladder Cancer

Abdominoplasty, Panniculectomy and Lipectomy
Allogeneic Hematopoietic Transplant for Genetic Diseases and Acquired Anemia
Allogeneic Stem Cell Transplantation for Myelodysplastic Syndromes
Ankle Replacement, Total
Artificial Intervertebral Disc
Autologous Chondrocyte Implantation
Autologous Fat Grafting to the Breast
Automated Percutaneous and Endoscopic Discectomy
Axial Lumbosacral Interbody Fusion
Balloon Sinuplasty for Treatment of Chronic Sinusitis
Bioengineered Skin and Tissue
Bone Morphogenetic Protein
Breast Surgeries
Bronchial Thermoplasty
Cardiac (Heart) Transplantation
Carotid Artery Angioplasty / Stenting (CAS)
Catheter Ablation of the Pulmonary Veins as a Treatment for Atrial Fibrillation
Chromoendoscopy as an Adjunct to Colonoscopy
Cochlear Implant
Composite Allotransplantation of the Hand and Face
Computer Assisted Surgical Navigational Orthopedic Procedures
Congenital Heart Defect, Repair Devices
Cord Blood as a Source of Stem Cells
Cosmetic and Reconstructive Surgery
Cryosurgical Ablation of Primary or Metastatic Liver Tumors
Cryosurgical Ablation of Miscellaneous Solid Tumors Other Than Liver, Prostate, or Dermatologic Tumors
Decompression of the Intervertebral Disc Using Laser Energy (Laser Discectomy) or Radiofrequency Coblation (Nucleoplasty)
Dental Inpatient and Outpatient Services
Dental, Reconstructive Services
Electrical Bone Growth Stimulation
Electrothermal Arthroscopic Capsulorrhaphy
Endobronchial Valves
Endothelial Keratoplasty
Endovascular Procedures for Intracranial Arterial Disease
Epiretinal Radiation Therapy for Age-Related Macular Degeneration
Extracorporeal Shock Wave Treatment for Musculoskeletal Conditions and Wound Healing
Facet Joint Denervation
Functional Endoscopic Sinus Surgery (FESS)
Gastric Electrical Stimulation
Gastroesophageal Reflux Disease, Transendoscopic Therapies
Gender Reassignment Surgery
Heart-Lung Transplantation
Hematopoietic Stem-Cell Transplant for Non Hodgkin's Lymphomas
Hematopoietic Stem-Cell Transplantation for Acute Lymphoblastic Leukemia
Hematopoietic Stem-Cell Transplantation for Acute Myeloid Leukemia
Hematopoietic Stem-Cell Transplantation for Autoimmune Diseases
Hematopoietic Stem-Cell Transplantation for Breast Cancer
Hematopoietic Stem-Cell Transplantation for Chronic Myelogenous Leukemia
Hematopoietic Stem-Cell Transplantation for CNS Embryonal Tumors and Ependymoma
Hematopoietic Stem-Cell Transplantation for CLL and SLL
Hematopoietic Stem-Cell Transplantation for Epithelial Ovarian Cancer
Hematopoietic Stem-Cell Transplantation for Hodgkin Lymphoma
Hematopoietic Stem-Cell Transplantation for Malignant Astrocytomas and Gliomas
Hematopoietic Stem-Cell Transplantation for Miscellaneous Solid Tumors in Adults
Hematopoietic Stem-Cell Transplantation for Multiple Myeloma
Hematopoietic Stem-Cell Transplantation for Primary Amyloidosis
Hematopoietic Stem-Cell Transplantation for Solid Tumors of Childhood
Hematopoietic Stem-Cell Transplantation for Waldenstrom Macroglobulinemia
Hematopoietic Stem-Cell Transplantation in the Treatment of Germ Cell Tumors
Hip Resurfacing
Hyperthemic Intraperitoneal Chemotherapy
Intradiscal Electrothermal (IDET) Annuloplasty and Percutaneous Intradiscal Radiofrequency Annuloplasty
Islet Cell Transplantation
Image Guided Minimally Invasive Lumbar Decompression (IG-MLD) for Spinal Stenosis
Implantable Bone Conduction Hearing Aids
Implantable Cardioverter Defibrillator
Implantation of Intrastromal Corneal Ring Segments
Injectable Bulking Agents for the Treatment of Urinary and Fecal Incontinence
Interspinous Fixation (Fusion) Devices
Intravitreal Implant
Keratoprosthesis
Laser Treatment of Port Wine Stains
Liver Transplant
Lumbar Spine Fusion Surgery
Lung and Lobar Lung Transplantation
Lung Volume Reduction Surgery
Lysis of Epidural Adhesions
Mechanical Embolectomy for Treatment of Acute Stroke
Meniscal Allografts and Other Meniscal Implants
Microwave Tumor Ablation
Mohs' Micrographic Surgery
Orthognathic Surgery
Osteochondral Grafting in the Treatment of Articular Cartilage Lesions
Pancreas Transplant
Percutaneous Electrical Nerve Stimulation (PENS) or Neuromodulation Therapy
Percutaneous Left Atrial Appendage Closure Device for Stroke Prevention
Plugs for Fistula Repair
Posterior Tibial Nerve Stimulation for Voiding Dysfunction
Pulmonary Artery Balloon Angioplasty, Percutaneous Transluminal Approach
Radiofrequency Ablation of Miscellaneous Solid Tumors Excluding Liver Tumors
Radiofrequency Ablation of the Renal Nerves as a Treatment of Hypertension
Radiosurgery, Stereotactic Approach
Reconstructive Eyelid Surgery and Brow Lift
Refractive Surgery
Renal (Kidney) Transplantation
Retinal Prosthesis
Rhinoplasty
Sacral Nerve Neuromodulation/Stimulation for Pelvic Floor Dysfunction
Sacroiliac Joint Fusion
Saturation Biopsy for Diagnosis and Staging of Prostate Cancer
Semi implantable and fully implantable middle ear hearing aid
Small Bowel, Small Bowel with Liver, or Multivisceral Transplant
Spinal Cord Stimulation
Spinal Surgery Using Interspinous Distraction Technology
Subtalar Arthroereisis
Surgery for Femoroacetabular Impingement
Surgery for Morbid Obesity
Surgery for Obstructive Sleep Apnea and Upper Airway Resistance Syndrome
Surgical Deactivation of Migraine Headache Trigger Sites
Surgical Treatment of Chest Wall Deformities (Congenital or Acquired)
Surgical Ventricular Restoration
Temporomandibular Joint Dysfunction (TMJD)
Tinnitus Treatment
Topical Negative Pressure Therapy for Wounds
Total Facet Arthroplasty
Transanal Endoscopic Microsurgery
Transanal Radiofrequence Treatment of Fecal Incontinence
Transcatheter Closure of Ventricular Septal Defects
Transcatheter Heart Valve Implantation
Ultrasound Accelerated Fracture Healing Device
Vagus Nerve Stimulation
Varicose Veins, Treatment for
Vesicoureteral Reflux, Treatment with Periureteral Bulking Agents
Viscocanalostomy and Canaloplasty