(19) "Medical services" for plan 1 members, shall include the following as minimum services to be provided. Reasonable charges for these services shall be paid in accordance with RCW 41.26.030.
- (a) Hospital expenses: These are the charges made by a hospital, in its own behalf, for
- (i) Board and room not to exceed semiprivate room rate unless private room is required by the attending physician due to the condition of the patient.
- (ii) Necessary hospital services, other than board and room, furnished by the hospital.
- (b) Other medical expenses: The following charges are considered "other medical expenses," provided that they have not been considered as "hospital expenses".
- (i) The fees of the following:
- (A) A physician or surgeon licensed under the provisions of chapter 18.71 RCW;
- (B) An osteopathic physician and surgeon licensed under the provisions of chapter 18.57 RCW;
- (C) A chiropractor licensed under the provisions of chapter 18.25 RCW.
- (ii) The charges of a registered graduate nurse other than a nurse who ordinarily resides in the member's home, or is a member of the family of either the member or the member's spouse.
- (iii) The charges for the following medical services and supplies:
- (A) Drugs and medicines upon a physician's prescription;
- (B) Diagnostic X-ray and laboratory examinations;
- (C) X-ray, radium, and radioactive isotopes therapy;
- (D) Anesthesia and oxygen;
- (E) Rental of iron lung and other durable medical and surgical equipment;
- (F) Artificial limbs and eyes, and casts, splints, and trusses;
- (G) Professional ambulance service when used to transport the member to or from a hospital when injured by an accident or stricken by a disease;
- (H) Dental charges incurred by a member who sustains an accidental injury to his or her teeth and who commences treatment by a legally licensed dentist within ninety days after the accident;
- (I) Nursing home confinement or hospital extended care facility;
- (J) Physical therapy by a registered physical therapist;
- (K) Blood transfusions, including the cost of blood and blood plasma not replaced by voluntary donors;
- (L) An optometrist licensed under the provisions of chapter 18.53 RCW.
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