Nevada § 695G.055 “Medically necessary” defined

Nevada Statutes

§ 695G.055 — “Medically necessary” defined

Nevada § 695G.055

Title 57INSURANCE

Ch. 695GManaged

GENERAL PROVISIONS

This text of Nevada § 695G.055 (“Medically necessary” defined) is published on Counsel Stack Legal Research, covering Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Nev. Rev. Stat. § 695G.055 (2026).

Text

“Medically necessary” means health care services or products that a prudent physician would provide to a patient to prevent, diagnose or treat an illness, injury or disease, or any symptoms thereof, that are necessary and:

1.Provided in accordance with generally accepted standards of medical practice;

2.Clinically appropriate with regard to type, frequency, extent, location and duration;

3.Not primarily provided for the convenience of the patient, physician or other provider of health care;

4.Required to improve a specific health condition of an insured or to preserve the existing state of health of the insured; and

5.The most clinically appropriate level of health care that may be safely provided to the insured.

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“Medically necessary” means health care services or products that a prudent physician would provide to a patient to prevent, diagnose or treat an illness, injury or disease, or any symptoms thereof, that are necessary and:
1. Provided in accordance with generally accepted standards of medical practice;
2. Clinically appropriate with regard to type, frequency, extent, location and duration;
3. Not primarily provided for the convenience of the patient, physician or other provider of health care;
4. Required to improve a specific health condition of an insured or to preserve the existing state of health of the insured; and
5. The most clinically appropriate level of health care that may be safely provided to the insured.