Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES
Article 10 - HEALTHY INDIANA PLAN
Rule 7 - Benefits and Medical Policy
Section 7-11 - Self-referral services
Universal Citation: 405 IN Admin Code 7-11
Current through March 20, 2024
Authority: IC 12-15-44.5-9
Affected: IC 12-15-11; IC 12-15-44.5; IC 27-8-14.5-6
Sec. 11.
(a) A member may receive the following covered services without a referral from the member's primary medical provider or prior authorization or precertification from the member's managed care organization:
(1) Family planning services.
(2) Emergency services.
(b) A member may receive the following services without a referral from the member's primary medical provider, provided the service is a covered service under such member's benefits package and subject to any requirements established by the managed care organization regarding the use of in-network providers:
(1) Psychiatric services provided by a
provider licensed under IC 12-15-11.
(2) Behavioral health services.
(3) Immunization services.
(4) Diabetes self-management training
services, as set forth in IC
27-8-14.5-6.
(5) Chiropractic services.
(6) Eye care services, except for surgical
services on the eye.
(7) Podiatric
services.
(8) Urgent care
services.
Disclaimer: These regulations may not be the most recent version. Indiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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