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Autism treatment .................................................................................................................................................................... 39 Bariatric surgery ....................................................................................................................................................................... 39 Behavioral health .................................................................................................................................................................... 39 Breast health screening tests ............................................................................................................................................. 42 Care Gap Closure Program ................................................................................................................................................. 42 Care management .................................................................................................................................................................. 42 Chiropractic physician services ......................................................................................................................................... 43 Dental services.......................................................................................................................................................................... 43 Diabetes care supplies .......................................................................................................................................................... 44 Diabetes Control Program .................................................................................................................................................. 45 Diabetes education ................................................................................................................................................................ 45 Diabetes Prevention Program (DPP) .............................................................................................................................. 45 Diagnostic tests, laboratory, and x-rays ....................................................................................................................... 46 Dialysis ......................................................................................................................................................................................... 46 Durable medical equipment (DME), supplies, and prostheses........................................................................... 47 Emergency room ..................................................................................................................................................................... 49 End-of-life counseling .......................................................................................................................................................... 49 Family planning services ...................................................................................................................................................... 49 Foot care, maintenance ........................................................................................................................................................ 51 Gender affirming care ........................................................................................................................................................... 51 Genetic services ....................................................................................................................................................................... 51 Headaches, chronic migraine or chronic tension type ........................................................................................... 51 Hearing care (diseases and disorders of the ear) ..................................................................................................... 52 Hearing exam and hearing aids (instruments) .......................................................................................................... 52 Home health care .................................................................................................................................................................... 53 Hospice care .............................................................................................................................................................................. 53 Hospital services ...................................................................................................................................................................... 55 Infusion drug site of care program ................................................................................................................................. 56 Joint replacement surgery, knees and hips in the Centers of Excellence (COE) Program ..................... 56 Knee arthroplasty, total ........................................................................................................................................................ 59 Mammogram and Digital Breast Tomosynthesis (DBT) ........................................................................................ 60 Massage therapy ..................................................................................................................................................................... 60 Mastectomy and breast reconstruction ........................................................................................................................ 61 Mental health ............................................................................................................................................................................ 61 Naturopathic physician services ....................................................................................................................................... 61 Nurse line .................................................................................................................................................................................... 61 Nutrition counseling and therapy ................................................................................................................................... 61 2024 UMP Select (PEBB) Certificate of Coverage 9

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