La. Admin. Code tit. 50 § XV-9301

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

Section XV-9301 - General Provisions

A. The Medicaid Program shall provide coverage of substance abuse services rendered to Medicaid eligible recipients, under the age of 21.

B. Medicaid reimbursement for medically necessary substance abuse services shall only be provided to the Office of Behavioral Health for recipients under the age of 21 who receive outpatient treatment only. The Medicaid Program shall not provide reimbursement for inpatient services under these provisions.

C. Substance abuse services covered under the EPSDT Program shall include medically necessary clinic services and other medically necessary substance abuse services rendered to EPSDT recipients.

D. Medicaid recipients shall be the sole recipients of Medicaid covered substance abuse services and these services shall only be billed for the Medicaid recipient despite the presence of others who may be group or family participants.

La. Admin. Code tit. 50, § XV-9301

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 38:2371 (September 2012).

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