Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1223 - OUTPATIENT DRUG AND ALCOHOL CLINIC SERVICES
COVERED AND NONCOVERED SERVICES
Section 1223.12 - Outpatient services

Universal Citation: 55 PA Code ยง 1223.12
Current through Register Vol. 54, No. 12, March 23, 2024

The outpatient drug/alcohol clinic services specified in the Medical Assistance program fee schedule are covered only when provided by approved drug/alcohol outpatient clinics, when ordered by a licensed physician, to eligible outpatient recipients by or under the supervision of a licensed physician. Payment is limited to the services and subject to the conditions and limitations specified in Chapter 1150 (relating to Medical Assistance program payment policies) and the Medical Assistance program fee schedule, this chapter and Chapter 1101 (relating to general provisions). The Medical Assistance program is not considered to be a funding source for facility, project, program or Single County Authority maintenance or expansion but a program of fee for service reimbursement for actual covered medical and psychiatric services rendered to eligible outpatients in approved clinics.

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