Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 13 - BEHAVIORAL HEALTH SERVICES
Section 13-8 - Excluded Services

Universal Citation: WY Code of Rules 13-8

Current through December 21, 2024

(a) The following services are excluded:

(i) Clinical services which are not provided in person or via a telehealth modality, other than collateral contacts necessary to develop or implement a treatment plan;

(ii) Education, public education, public relations, and speaking engagements;

(iii) Day care;

(iv) Driving while under the influence (DUI) classes;

(v) Missed appointments;

(vi) Psychological testing done for the sole purpose of education diagnosis, school or institution admission or placement or Medicaid waiver eligibility assessments;

(vii) Record-keeping time, unless allowed by a specific service code;

(viii) Recreation and socialization without an active clinical treatment component as specified in the individual client's treatment plan;

(ix) Remedial or other formal education;

(x) Residential room, board, or care;

(xi) Substance abuse or mental health disorder prevention services;

(xii) Support groups, such as Alcoholics Anonymous or Narcotics Anonymous;

(xiii) Time spent preparing records or reports, except for up to three (3) hours for a licensed psychologist to prepare a formal report of test findings;

(xiv) Vocational services;

(xv) Services provided to a client with:
A. Sole Diagnostic and Statistical Manual (DSM) diagnosis of intellectual or cognitive disability;

B. DSM diagnosis of factitious disorder; or

C. DSM diagnosis of any ICD-10 "Z" code, unless the client's medical record contains a written statement signed by the affiliated clinical professional explaining why the treatment of a condition that is not classified as a mental disorder is medically necessary;

(xvi) Services provided by a school psychologist, except when provided pursuant to Medicaid Rules Chapter 52 School Based Services.

Disclaimer: These regulations may not be the most recent version. Wyoming 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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