Please note:

1. This tool is for outpatient Medical and Radiation Oncology services only.
2. Inpatient oncology is managed by the enrollee’s health plan.
3. This tool does not reflect a patient’s benefit coverage, nor does it include a detailed list of non-covered services (i.e., experimental procedures, cosmetic surgery, clinical trials, etc.). Refer to your Provider Manual or the enrollee’s Evidence of Coverage for coverage/limitations.