This brochure version is for internal use only.
 

 

2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(a). Medical Services and Supplies Provided by Physicians and Other Healthcare Professionals
Alternative/Manipulative Treatment

 

Note: We state whether or not the calendar year deductible applies for each benefit listed in this section.

Benefit Description

Alternative/Manipulative Treatment
Benefits for manipulative treatment and acupuncture are subject to a combined limit of 10 visits per person per calendar year
 
  • Acupuncture is covered when performed and billed by a healthcare provider who is licensed or certified to perform acupuncture by the state where the services are provided, and who is acting within the scope of that license or certification. See page 16 for more information.
     
    Note: See page 68 for our coverage of acupuncture when provided as anesthesia for covered surgery.
     
    Note: See page 45 for our coverage of acupuncture when provided as anesthesia for covered maternity care.
     
  • Manipulative treatment limited to:
     
    • Osteopathic manipulative treatment to any body region
       
    • Chiropractic spinal and/or extraspinal manipulative treatment

See Section 5(c), page 75, for facility benefits.


You Pay
Preferred: $25 copayment per visit (no deductible)

Non-preferred (Participating/Non-participating): You pay all charges

Note: You pay 30% of the Plan allowance (deductible applies) for agents, drugs, and/or supplies administered or obtained in connection with your care. (See page 128 for more information about “agents.”)

 

Benefit Description
Not covered:
 
  • Biofeedback
     
  • Self-care or self-help training


You Pay
All charges