Section 405 IAC 1-4.2-3 - Home health care services; general informationAuthority: IC 12-15-5-11; IC 12-15-21
Affected: IC 12-15-13-2
Sec. 3.
(a) Medicaid will reimburse HHAs for the following home health services: (1) Skilled nursing performed by a registered nurse or licensed practical nurse.(2) Home health aide services.(3) Physical and occupational therapies.(4) Speech pathology services.(6) Telehealth services. The services in this subsection must be provided within the limitations set forth in 405 IAC 5-16.
(b) Except as provided in subsection (c), all home health services require prior authorization by submitting a properly completed written request to the office. Prior authorization procedures for home health care are set forth in 405 IAC 5-16-3 and 405 IAC 5-16-3.1.(c) Prior authorization may be obtained by telephone under the circumstances and subject to the limitations set forth in 405 IAC 5-3-2(b)(3). Services ordered in writing by a physician prior to the patient's discharge from a hospital within the limitations set forth in 405 IAC 5-3-12(2) do not need prior authorization. Office of the Secretary of Family and Social Services; 405 IAC 1-4.2-3; filed Jul 18, 1996, 3:00p.m.: 19 IR 3376; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; filed Jun 18, 2007, 11:38 a.m.: 20070718-IR-405070031FRA; readopted filed Sep 19, 2007, 12:16p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAFiled 9/19/2014, 3:22 p.m.: 20141015-IR-405140194FRAFiled 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRAErrata filed 10/6/2016, 2:59 p.m.: 20161019-IR-405160452ACAFiled 12/21/2018, 3:11 p.m.: 20190116-IR-405180269FRAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA