Search results with tag "Therapy electroconvulsive therapy"

PRIOR AUTHORIZATION LIST - Paramount Health Care

PG0228 Electrical Stimulation Therapy ELECTROCONVULSIVE THERAPY (ECT) X X X X 00104, 90870 PG0485 Electroconvulsive Therapy (ECT) ELECTRONIC BRACHYTHERAPY NON-COVERED NON-COVERED X NON-COVERED 0182T, 0394T, 0395T PG0315 Electronic Brachytherapy ENDOMETRIAL ABLATION X X As of 1/1/2020 procedure 58563 requires a …

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