29 What Requires Precertification The PHS + Precer tification 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 services requiring precertification. Inpatient Services 1 Outpatient Services 1 All inpatient 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 scan s, 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) • External prosthetic applia nces • 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 precertificati on is required for your service, please contact Cigna at 800 - 244 - 6224.