S.D. Admin. R. 67:16:44:02

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

Section 67:16:44:02 - Covered services

Services covered under this chapter are limited to services which meet the following criteria:

(1) Medically necessary services covered under the provisions of chapters 67:16:01, 67:16:02, 67:16:06, 67:16:11, 67:16:12, 67:16:41, and 67:16:48;

(2) Provided to a recipient at a FQHC, RHC, or other outpatient setting, including the recipient's place of residence or a skilled nursing facility. Services provided at an inpatient or outpatient hospital are not covered; and

(3) Provided under the medical direction of a physician.

S.D. Admin. R. 67:16:44:02

23 SDR 109, effective 1/5/1997; 26 SDR 168, effective 7/1/2000; 37 SDR 53, effective 9/23/2010; 46 SDR 050, effective 10/10/2019

General Authority: SDCL 28-6-1(1)(2).

Law Implemented: SDCL 28-6-1(1)(2).

Scope of benefits - Clinic, 42 C.F.R. § 405.2411. Scope of services - Center, 42 C.F.R. § 405.2446.