Indiana Administrative Code
Title 407 - OFFICE OF THE CHILDREN'S HEALTH INSURANCE PROGRAM
Article 3 - BENEFITS AND MEDICAL POLICY
Rule 3 - CHIP; Coverage; Use of Medicaid Rules
Section 3-1 - Covered services
Universal Citation: 407 IN Admin Code 3-1
Current through September 18, 2024
Authority: IC 12-17.6-2-11
Affected: IC 12-17.6
Sec. 1.
(a) The following services will be covered by CHIP using the same coverage criteria, limitations, and procedures, including prior authorization, as Medicaid under rules adopted by the secretary at 405 IAC 5 unless a service is listed as noncovered in 407 IAC 3-13:
(1) Physician
services, except that office visits shall be reimbursed in accordance with
407 IAC
3-5-1.
(2)
Inpatient hospital, except that inpatient rehabilitation services are limited
to fifty (50) days per calendar year.
(3) Outpatient hospital.
(4) Laboratory and radiology.
(5) Certified nurse practitioner.
(6) Family planning services and
supplies.
(7) Certified
nurse-midwife.
(8)
Vision.
(9) Home health and clinic
services.
(10) Dental.
(11) Hospice.
(12) Diabetes self-management
training.
(13) Food supplements,
nutritional supplements, and infant formulas.
(14) Restricted utilization.
(15) Consultations and second
opinions.
(16)
Anesthesia.
(b) The following services will be covered by CHIP using the coverage criteria, limitations, and procedures described in 407 IAC 3-4 through 407 IAC 3-12:
(1) Early intervention services.
(2) Evaluation and management
services.
(3) Medical supplies and
equipment.
(4) Mental health and
substance abuse services.
(5)
Therapy services.
(6)
Transportation.
(7) Pharmacy
services.
(8) Podiatry
services.
(9) Chiropractic
services.
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