S.D. Admin. R. 44:06:02:06

Current through Register Vol. 51, page 67, December 16, 2024

Section 44:06:02:06 - Treatment services financially covered

The department may provide financial assistance through CSHS only for preauthorized medical and surgical services for the treatment of the eligible condition and for the preservation of the benefits derived from the treatment. To receive treatment services, the child shall be medically eligible for CSHS pursuant to §§ 44:06:02:04 and 44:06:01:08 and the child's family shall meet the financial eligibility specified in § 44:06:04:01.

Services covered under this article must be medically necessary. To be medically necessary, the covered services must meet the following conditions:

(1) It is consistent with the child's symptoms, diagnosis, or condition; and

(2) It is recognized as the prevailing standard and is consistent with generally accepted professional medical standards of the provider's peer group.

S.D. Admin. R. 44:06:02:06

33 SDR 106, effective 12/26/2006.

General Authority: SDCL 34-1-21.

Law Implemented: SDCL 34-1-21.