New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 320 - EARLY AND PERIODIC SCREENING, DIAGNOSIS AND TREATMENT (EPSDT) SERVICES
Part 6 - SCHOOL-BASED SERVICES FOR MAP ELIGIBLE RECIPIENTS UNDER TWENTY-ONE YEARS OF AGE
Section 8.320.6.15 - NON-COVERED SERVICES
Current through Register Vol. 35, No. 18, September 24, 2024
MAD school-based services billed in school settings are subject to the limitations and coverage restrictions that exist for other MAD services; see 8.301.3 NMAC. MAD does not cover the following services.
A. Services classified as educational.
B. Services to non-MAP eligible individuals.
C. Services billed by a practitioner outside his or her area of expertise.
D. Vocational training that is related solely to specific employment opportunities, work skills or work settings.
E. Services that duplicate services billed outside the school setting unless determined to be medically necessary and MAD or its designee gave prior authorization for the service.
F. Services not identified in the eligible recipient's IEP, IFSP, 504 plan, IHCP or other care plan.
G. Transportation services listed below: