Conn. Agencies Regs. § 17b-262-809

Current through December 27, 2024

Section 17b-262-809 - Services not covered

The department shall not pay for the following PRTF services that are not covered under Medicaid:

(a) procedures or services of an unproven, educational, social, research, experimental or cosmetic nature or for any diagnostic, therapeutic or treatment procedures in excess of those deemed medically necessary and appropriate by the department to treat the client's condition;

(b) services or items furnished for which the provider does not usually charge;

(c) services that do not directly relate to the client's diagnosis, symptoms or medical history;

(d) the day of discharge;

(e) a PRTF admission or a day of care that does not meet all the department's requirements for inpatient services;

(f) a day when the client is absent from the PRTF at the midnight census, unless the absence is a medically authorized overnight pass and part of the treatment plan; or

(g) costs associated with the education or vocational training of the client which shall be excluded from Medicaid payments.

Conn. Agencies Regs. § 17b-262-809

Adopted effective September 4, 2009