La. Admin. Code tit. 50 § XI-10301

Current through Register Vol. 50, No. 11, November 20, 2024

Section XI-10301 - Scope of Services [Formerly section 10501]

A. Medicaid reimbursement is limited to medically necessary services that are covered by the Medicaid State Plan and would be covered if furnished by a physician. The following services shall be covered:

1. services furnished by a physician within the scope of practice of his profession under Louisiana law;

2. services furnished by a:

a. physician assistant;

b. nurse practitioner;

c. nurse midwife;

d. clinical social worker;

e. clinical psychologist; or

f. dentist;

3. services and supplies that are furnished as an incident to professional services furnished by all eligible professionals;

4. other ambulatory services; and

5. diabetes self-management training (DSMT) services.

B. The department shall provide coverage of diabetes self-management training services rendered to Medicaid beneficiaries diagnosed with diabetes mellitus.

1. Repealed.

C. The department shall provide coverage for fluoride varnish applications performed in the FQHC.

1. - 2.b. Repealed.

La. Admin. Code tit. 50, § XI-10301

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 30:2328 (October 2004), repromulgated LR 30:2487 (November 2004), amended LR 32:1902 (October 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 37:2629 (September 2011), LR 39:3076 (November 2013), Amended by the Department of Health, Bureau of Health Services Financing, LR 421520 (9/1/2016), Amended LR 4746 (1/1/2021).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.