Section 363.307 - Medical Necessity(a) PDN services are available to EPSDT-eligible recipients when the services are medically necessary to correct or ameliorate the recipient's disability or physical or mental illness or condition. The services correct or ameliorate when they improve, maintain, or slow the deterioration of the recipient's health status.(b) Medical necessity must be documented in the recipient's prior authorization request.1 Tex. Admin. Code § 363.307
The provisions of this §363.307 adopted to be effective March 31, 1999, 23 TexReg 13077; transferred effective September 1, 2002, as published in the Texas Register December 6, 2002, 27 TexReg 11527; Amended to be effective January 1, 2006, 30 TexReg 8661; Adopted by Texas Register, Volume 40, Number 41, October 9, 2015, TexReg 7059, eff. 10/15/2015