Services not covered by Priority Health

Page last updated on: 5/28/25

There are hundreds of services not covered by our medical plans and it's impossible to list them all, but here is a brief list of some that cause frequent inquiries.

Service or device

Medical policy

Abortion, recurrent spontaneous

91156

Automated percutaneous lumbar discectomy (APLD)

91581

Autopsy

91054

AxiaLIF™ lumbar interbody fusion

91581

Cingulotomy


Extracorporeal shock wave therapy (ECWT)

91527

IDET and other thermal intradiscal procedures (TIPs)

91581

Intracranial angioplasty and stenting

91495

Irreversible electroporation (IRE) or Nanoknife®

91599

Patellofemoral replacement for isolated osteoarthritis of the knee

91571

Phototherapy, monochromatic (anodyne therapy/ MIRE therapy/ low-level light therapy)

91486

Platelet-rich plasma/ platelet-rich fibrin matrix 

91553

Refractive keeratoplasty/ LASIK

91529

Respite care


Sperm and oocyte retrieval and storage

91393

Therapy, tinnitus retraining

91482

Thermal capsulorrhaphy

91551

Thermography

91355

Ultrasound, high-intensity focused

91601

Ultrasound ablation of uterine fibroids

91573