407 Ind. Admin. Code 3-3-1

Current through December 4, 2024
Section 407 IAC 3-3-1 - Covered services

Authority: IC 12-17.6-2-11

Affected: IC 12-17.6

Sec. 1.

(a) The following services will be covered by CHIP using the same coverage criteria, limitations, and procedures, including prior authorization, as Medicaid under rules adopted by the secretary at 405 IAC 5 unless a service is listed as noncovered in 407 IAC 3-13:
(1) Physician services, except that office visits shall be reimbursed in accordance with 407 IAC 3-5-1.
(2) Inpatient hospital, except that inpatient rehabilitation services are limited to fifty (50) days per calendar year.
(3) Outpatient hospital.
(4) Laboratory and radiology.
(5) Certified nurse practitioner.
(6) Family planning services and supplies.
(7) Certified nurse-midwife.
(8) Vision.
(9) Home health and clinic services.
(10) Dental.
(11) Hospice.
(12) Diabetes self-management training.
(13) Food supplements, nutritional supplements, and infant formulas.
(14) Restricted utilization.
(15) Consultations and second opinions.
(16) Anesthesia.
(b) The following services will be covered by CHIP using the coverage criteria, limitations, and procedures described in 407 IAC 3-4 through 407 IAC 3-12:
(1) Early intervention services.
(2) Evaluation and management services.
(3) Medical supplies and equipment.
(4) Mental health and substance abuse services.
(5) Therapy services.
(6) Transportation.
(7) Pharmacy services.
(8) Podiatry services.
(9) Chiropractic services.

407 IAC 3-3-1

Office of the Children's Health Insurance Program; 407 IAC 3-3-1; filed May 3, 2000, 2:02 p.m.: 23 IR 2235; readopted filed May 22, 2006, 3:22 p.m.: 29 IR 3424; readopted filed Jun 18, 2012, 11:23 a.m.: 20120718-IR-407120202RFA