Diagnostic Services: FSA Eligibility
What are diagnostic services?
Diagnostic services are an invaluable facet of modern medicine that make up a diverse selection of medical services and care techniques that are used to determine the presence of a disease or dysfunction in the body. As opposed to preventive care like immunizations, lab tests and screenings that are used to prevent illness or detect issues before symptoms arise, diagnostic services are utilized as a response to a patient's existing issues, examining specific symptoms and diagnosing the issue based on test results and other observations (The National Academies Press).
In this way, specific medical tests could have both preventive and diagnostic functions. For instance, a physician may take a patient's blood pressure as a regular means of monitoring his/her risks for hypertension as a preventative measure, but if this patient had come in after experiencing chest pain, this blood pressure check would be considered a diagnostic test because it is done as a response to present symptoms and risk factors.
As such, diagnostic services encompass a huge range of potential tests, treatments and medical services that are performed in doctor's offices, outpatient facilities and hospitals. The IRS has ruled that these services are covered under consumer-directed healthcare accounts as long as they fit the definition of IRC 213(d)(1). According to Under IRC 213(d)(1), "medical care includes amounts paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body." In some cases, a benefits administrator may require a Letter of Medical Necessity (LMN) for some forms of treatment, but by and large, diagnostic services are a normal facet of medical care that are covered by FSAs, HSAs and HRAs.