111. Spinal cord stimulation for chronic neuropathic pain 112. Spinal injections, therapeutic (except as described under “Spinal injections” on page 70) of the following types: ◦ Facet injections ◦ Intradiscal injections ◦ Medial branch nerve block injections 113. Spinal surgical procedures known as vertebroplasty, kyphoplasty, and sacroplasty 114. Stem cell therapies for musculoskeletal conditions 115. Stereotactic body radiation therapy for the treatment of primary tumor of the following cancer types: ◦ Bone ◦ Head and neck ◦ Adrenal ◦ Melanoma ◦ Merkel cell ◦ Breast ◦ Ovarian ◦ Cervical 116. Stereotactic radiation surgery for conditions other than central nervous system primary and metastatic tumors 117. Surrogacy 118. Telephone or virtual consultations or appointments, except as described under “Telemedicine services” on page 77 119. Tinnitus specific therapies including, but not limited to: ◦ Tinnitus retraining therapy (TRT) ◦ Neuromonics tinnitus treatment (NTT) ◦ Tinnitus activities treatment (TAT) ◦ Tinnitus-masking counseling 120. Transcutaneous vagal nerve stimulation (does not include or apply to support of previous implanted VNS) 121. Transcutaneous vagal nerve stimulation for epilepsy or depression 122. Travel, transportation, and lodging expenses, except as specified for ambulance services covered by the plan (see page 39), or approved travel and lodging costs related to the COE Program for single knee and single hip replacement (see page 58) and for spine care (see page 70) 123. Treatment of varicose veins with Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA), Sclerotherapy, and Phlebectomy in patients with pregnancy, active infection, peripheral arterial disease, or deep vein thrombosis (DVT) 114 2024 UMP CDHP (PEBB) Certificate of Coverage