30 What Requires Precertification The PHS+ Precertification Program includes precertification for all non - emergency inpatient admissions, post admission review for emergency admissions, and many outpatient services. A list is provided below that shows representative servi ces requiring precertification. Inpatient Services 1 Outpatient Services 1 All inpatie nt admissions and non - obstetric observation stays such as: • Acute hospitals • Skilled nursing facilities • Rehabilitation facilities • Long - term acute care facilities • Hospice care • Transfers between inpatient facilities • Experimental and investigational procedures • Cosmetic procedures • Maternity stays longer than 48 hours (vaginal delivery) or 96 hours (cesarean section) • Certain outpatient surgical procedures • High - tech radiology (MRI, CAT scans, PET scans, nuclear cardiology) • Injectable drugs (other than self - injectables) • Durable medical equipment (insulin pumps, specialty wheelchairs, etc.) • Home health care/home infusion therapy • Dialysis (to direct to a participating facility) • E xternal prosthetic appliances • Speech therapy • Cosmetic or reconstructive procedures • Infertility treatment • Sleep management • Transplants • Radiation therapy • Musculoskeletal treatment (including pain management and major joint surgery) 1 This list does not include all services that require precertification, or any Plan limitations/exclusions that might apply. Coverage of any service is subject to Plan provisions in effect when the service is rendered. If you are not sure if precertification is required for your service, please contact Cigna at 800 - 244 - 6224.