405 Ind. Admin. Code 5-21.7-15

Current through January 8, 2025

Section 405 IAC 5-21.7-15 - Services: general provisions

Authority: IC 12-8-6.5-5; IC 12-15

Affected: IC 12-13-7-3; IC 12-29; IC 25-23.6-10.5; IC 25-27.5-5

Sec. 15.

(a) All CMHW services provided to a member must meet the following requirements:

(1) Be supported by the member's level of need.

(2) Be documented in the member's plan of care.

(b) A provider shall maintain documentation for services provided to a CMHW services member in accordance with the requirements under 405 IAC 1-5-1.

(c) Provider reimbursement for CMHW services is subject to, but not limited to, the following:

(1) The member's eligibility for services.

(2) The provider's qualifications and certification.

(3) Prior authorization by the office.

(4) The scope, limitations, and exclusions of the services.

405 IAC 5-21.7-15

Office of the Secretary of Family and Social Services; 405 IAC 5-21.7-15; filed Dec 18, 2013, 11:13 a.m.: 20140115-IR-405130211FRA

Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA

Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA

Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA