IC 27-1-37.5-5.4: "Medically necessary"

Sec. 5.4. As used in this chapter, "medically necessary" means a health care service that a prudent health care provider would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease, or symptoms in a manner that is:

(1) in accordance with generally accepted standards of medical practice;

(2) clinically appropriate in terms of type, frequency, extent, site, and duration; and

(3) not primarily for:

(A) the economic benefit of the health plan or purchaser; or

(B) the convenience of the health plan, patient, treating physician, or other health care provider.