Rhode Island Code of Regulations
Title 210 - Executive Office of Health and Human Services
Chapter 30 - Medicaid for Children, Families, and Affordable Care Act (ACA) Adults
Subchapter 05 - Service Delivery Options
Part 2 - Medicaid Managed Care Delivery Options
Section 210-RICR-30-05-2.27 - Services that are Not Covered by Medicaid
Universal Citation: 210 RI Code of Rules 30 05 2.27
Current through March 25, 2025
A. Non-covered services - The following services are not covered under the Medicaid program:
1. Experimental procedures,
except as required by Rhode Island State law;
2. Private rooms in hospitals (unless
medically necessary);
3. Cosmetic
surgery;
4. Medications that treat
erectile dysfunction or other sexual disorders;
5. Infertility treatment services;
and
6. Any portion of services that
exceeds fifteen (15) days provided in an Institution for Mental Diseases (IMD)
for individuals between the ages of twenty-one (21) to sixty-four (64). RHP
managed care enrollees may access IMDs.
B. Out-of-State Coverage - EOHHS does not routinely provide coverage for out-of State services with certain exceptions: Medicaid services provided in border communities are covered and emergency services are covered, within limits, at the discretion of EOHHS or the managed care organization.
Disclaimer: These regulations may not be the most recent version. Rhode Island 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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