Nonreimbursable Services

The following services are not reimbursable: (A) drugs and durable medical equipment prescribed for take-home use that are readily available from pharmacies or medical providers; (B) the cost of any treatment or testing of a member or of a specimen from a member who is not an inpatient in the psychiatric inpatient hospital; (C) room-and-board services on the day of discharge (unless the day of discharge is also the day of admission); (D) leave-of-absence days; (E) research or the provision of experimental or unproven procedures; (F) private hospital rooms, except when medically necessary; and (G) services furnished by the emergency room or outpatient department on the day of admission, during the inpatient stay, or on the day of discharge.