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Are experimental or investigational procedures covered by the fee schedule?

April 26, 2017Covered experimental fee investigational procedures schedule

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Are experimental or investigational procedures covered by the fee schedule?

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No, the service must be widely accepted by the practicing peer group, based on scientific criteria, and determined to be reasonably safe. It must not be of an experimental, investigational, or research in nature except in those instance in which prior approval of the payer has been obtained.