23 Miss. Code. R. 206-1.4

Current through October 31, 2024
Rule 23-206-1.4 - Non-Covered Services
A. The Division of Medicaid does not cover community mental health services that:
1. Are not medically necessary,
2. Are not prior authorized by the Division of Medicaid, Utilization Management/Quality Improvement Organization (UM/QIO) or designee, if required, and
3. Are not part of a plan of care or treatment plan approved by a team member qualified to approve the service being provided.
B. The Division of Medicaid does not cover the following activities and/or services:
1. Time spent completing paperwork,
2. Telephone contacts, unless included in the service definition,
3. Recreational activities,
4. Educational interventions,
5. Travel time,
6. Missed or canceled appointments,
7. Room and board, and/or
8 Services provided to a beneficiary during an inpatient stay, unless included in the service definition.
C. The Division of Medicaid does not cover services and/or programs that do not meet the standards of the licensing/certifying agency when applicable.

23 Miss. Code. R. 206-1.4

42 C.F.R. §§ 440.130, 440.169; Miss. Code Ann. §§ 43-13-117, 43-13-121.
Amended 9/1/2020
Amended 11/1/2020
Amended 7/1/2021