Why Not Covered:
Emergency care requires immediate access to hospital-based equipment, specialists, and facilities. Legally and ethically, DPC providers cannot delay or substitute emergency intervention. Parents are always advised to dial 911 or go to the ER for serious or life-threatening conditions.

Why Not Covered:
Inpatient hospital services fall under the jurisdiction of hospital systems, insurance billing, and credentialed specialists. DPC physicians generally do not have admitting privileges, and cannot legally bill or manage inpatient care. Hospitalizations must be handled through traditional health systems and insurance.

Why Not Covered:
DPC focuses on general pediatric care. When specialty-level evaluation or intervention is needed, ethical care requires referral to board-certified specialists. DPC clinics are not equipped for specialty diagnostics or procedures, and insurance typically handles those costs separately.

Why Not Covered:
Surgeries involve operative facilities, anesthesia, post-operative care, and significant risk. Legally and practically, DPC practices do not hold the infrastructure or liability protection for such services. These must be performed under licensed surgical teams in accredited facilities.

Why Not Covered:
Most DPC offices do not house radiology equipment due to high cost and regulatory requirements. Ordering and interpretation must often be done in partnership with imaging centers, and those services are billed separately to insurance or self-pay.

Why Not Covered:
Legally, vaccines provided through the federally funded VFC program must be administered under specific guidelines and reporting requirements. Most DPC clinics opt to refer eligible patients to public health clinics for free vaccines to avoid conflicts with federal program compliance.

Why Not Covered:
DPC practices often include basic point-of-care testing. However, labs sent to Quest, LabCorp, or hospital-affiliated facilities operate independently. These external labs bill based on insurance status or self-pay agreements, which DPC clinics cannot control.

Why Not Covered:
While DPC providers can prescribe medications, they do not dispense them in-house unless operating a licensed pharmacy. Drug costs, insurance formularies, and pharmacy pricing fall outside the clinic’s financial control and are billed directly to the patient or insurer.

Why Not Covered:
These specialties fall outside the scope of general pediatrics. Ethically and clinically, patients require care from licensed dentists, optometrists, or audiologists. DPC providers can screen and refer but cannot substitute for those services.

Why Not Covered:
International travel forms may require country-specific vaccines, legal attestation, or regulatory compliance outside a DPC provider’s scope. These forms often need documentation not supported by routine clinical records and may expose the provider to legal liability.

Why Not Covered:
Legal reports (e.g., for custody, abuse investigations, fitness to testify) require impartial documentation and often court appearances. Ethically, a primary care DPC provider cannot serve as both treating physician and legal evaluator without a conflict of interest.

Why Not Covered:
While we provide basic behavioral health guidance, long-term therapy and psychiatric medication management require specialists such as child psychologists or psychiatrists. Ethically and clinically, complex mental health needs fall outside general pediatric practice scope.