Wyoming Administrative Code
Agency 048 - Health, Department of
Sub-Agency 0037 - Medicaid
Chapter 6 - HEALTH CHECK (FORMERLY EPSDT) PROGRAM
Section 6-8 - Covered services
Universal Citation: WY Code of Rules 6-8
Current through September 21, 2024
(a) HEALTH CHECKs.
(b) Treatment and referral services. Treatment and referral services are covered pursuant to the other rules of the Department.
(c) Expanded services. Expanded services are covered services if:
(i) There is a physician referral;
(ii) Prior authorized, if required;
and
(iii) Furnished in the most
cost effective setting, as determined by the Division.
(d) Transportation services.
(i) Ambulance transportation. Ambulance
transportation is covered pursuant to Chapter 15.
(ii) Administrative transportation. Necessary
transportation to obtain covered
services is available through the local office of DFS.
(e) Excluded services. HEALTH CHECK treatment and referral services or expanded services do not include:
(i) Services or treatments not
approved by the FDA;
(ii)
Experimental procedures;
(iii)
Procedures that are not medically necessary;
(iv) Procedures that are not generally
recognized as an accepted modality of medical practice or treatment;
(v) Educational services.
(f) Limits on services. HEALTH CHECK services otherwise reimbursable if furnished in a particular setting must be furnished in that setting and are subject to the reimbursement rules of the Department.
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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