23 Miss. Code. R. 215-1.4

Current through December 10, 2024

Rule 23-215-1.4 - Non-Covered Services

The Division of Medicaid does not cover:

A. Home health services provided to a beneficiary who can receive the services in an outpatient setting including, but not limited to:

1. Outpatient hospital,

2. Free-standing clinic, or

3. Nursing facility.

B. Services that are not medically necessary.

C. Services that are not part of a written plan of care reviewed and recertified every sixty (60) days by a physician or non-physician practitioner (NPP).

D. Services provided by a home health agency that has not met the requirements for participation in Medicare.

E. Services that have not been ordered by a physician or (NPP).

F. Services provided in another state where the beneficiary has been a resident for more than thirty (30) days.

G. The following services under the home health benefit:

1. Physical therapy,

2. Occupational therapy, and/or

3. Speech-language pathology and audiology services.

23 Miss. Code. R. 215-1.4

42 C.F.R. § 440.70; Miss. Code Ann. §§ 43-13-117, 43-13-121.

Amended 9/1/2018

Amended 7/1/2021