Section 40-10 - Covered services (a) Inpatient psychiatric services for individuals under age 21 furnished to a recipient under age twenty-one in an FPRTC are covered services if provided: - (i) After a certification of need for services has been completed pursuant to subsection 8(a);
- (ii) After a certification of need for services has been completed pursuant to subsection 8(b);
- (iii) After the services have been prior authorized, subject to subsection 9(g);
- (iv) Pursuant to an individual written plan of care which provides for active treatment;
- (v) By or under the supervision of a physician;
- (vi) The recipient is under age twenty-one;
- (vii) Outpatient, community-based services have failed; and
- (viii) The reciept has a psychiatric diagnosis which meets the criteria of Axis I of the DSM-IV, is medically stable, and acute, inpatient hospital services are not medically necessary.
(b) Court-ordered placement. Services furnished to a reciept in a court-order placement are reimbursable if they meet the criteria of (a), except that such services may be prior authorized within seven calendar days of admission.
048-40 Wyo. Code R. § 40-10