The determination that the health care professional was acting according to standard practices in providing a particular procedure for an individual with a particular diagnosis is known as:

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The determination that a health care professional is acting according to standard practices is known as medical necessity. This term refers to the idea that the procedure being provided is necessary and appropriate for the patient's diagnosis and condition. Reimbursement refers to payment for services provided, services are the specific medical treatments or interventions being offered, and treatments are the courses of action taken to address a patient's health condition. While all of these concepts are related to medical care, only medical necessity addresses the question of whether a particular procedure is appropriate and standard for a given diagnosis.

The Determination That the Health Care Professional Was Acting According