Section 17b-262-821 - Services covered(a) The department shall pay providers for those procedures listed in the department's behavioral health clinic fee schedule, provided such services are: (1) Within the clinic's scope of practice as described in sections 19a-495-550, 19a-495-570, 17a-20-11 or 17a-147-1 of the Regulations of Connecticut State Agencies;(2) Medically necessary to treat the client's condition; and(3) Furnished in the clinic or a satellite site of the clinic.(b) When a procedure or service requested by a provider is not on the department's behavioral health clinic fee schedule, prior authorization is required. In such instances the provider shall submit a prior authorization request to the department or its agent including, but not limited to documentation showing the medical necessity for the service or procedure.(c) The department shall pay for behavioral health clinic services and for EPSDT special services.Conn. Agencies Regs. § 17b-262-821
Effective October 9, 2013