Article 4. Scope and Duration of Benefits | MidpageArticle 4. Scope and Duration of Benefits
State of California
51301Schedule of Benefits.51303General Provisions.51304Benefit Limitations.51305Physician Services.51305.1Criteria for the Performance of Sterilization.51305.2Requirements for Sterilization Other Than Emergency Sterilization. [Repealed]51305.3Informed Consent Process for Sterilization.51305.4Certification of Informed Consent for Sterilization.51305.5Additional Requirements for Informed Consent Process for Elective Sterilization. [Repealed]51305.6Hysterectomy.51305.7Noncompliance.51305.8Effective Date. [Repealed]51305.9Interim Coverage of Intermediate and Comprehensive Ophthalmological Services for Nonaphakic Beneficiaries. [Repealed]51306Optometry Services.51306.1Interim Coverage of Optometric Services for Nonaphakic Beneficiaries over 21. [Repealed]51307Dental Services. [Repealed]51308Chiropractic Services.51308.5Acupuncture Services.51309Psychology, Physical Therapy, Occupational Therapy, Speech Pathology and Audiological Services.51309.5Scope of Sign Language Interpreter Services.51310Podiatry Services.51311Laboratory, Radiological, and Portable Imaging Services.51312Prayer or Spiritual Healing.51313Pharmaceutical Services and Prescribed Drugs.51313.3Limitations on Coverage of Drugs on the Medi-Cal List of Contract Drugs.51313.6Drug Evaluation Criteria.51314Rehabilitation Center Outpatient Services.51315Amount, Scope, Duration, Limitation and Prior Authorization of Benefits for Orthotic and Prosthetic Appliances and Services.51315.1Requirements Applicable to the Prior Authorization of Orthotic Appliances and Services.51315.2Requirements Applicable to the Prior Authorization of Prosthetic Appliances and Services.51316Respiratory Care Services.51317Eyeglasses, Contact Lenses, Low Vision Aids, Prosthetic Eyes and Other Eye Appliances.51317.1Interim Coverage of Eyeglass Lenses. [Repealed]51319Hearing Aids.51320Medical Supplies.51321Durable Medical Equipment.51323Medical Transportation Services.51325Blood and Blood Derivatives.51326Nurse Anesthetist Services.51327Inpatient Hospital Services.51328Outpatient Heroin Detoxification Services.51329Rehabilitation Center Services. [Repealed]51330Chronic Hemodialysis.51330.1Renal Homotransplantation.51331Hospital Outpatient Department Services and Organized Outpatient Clinic Services.51331.5Rural Health Clinic Services.51332Organized Outpatient Clinic Services. [Repealed]51333Other Organized Outpatient Services. [Repealed]51334Intermediate Care Services.51335Skilled Nursing Facility Services.51335.1Transitional Inpatient Care Services. [Repealed]51335.5Subacute Care Services.51335.6Pediatric Subacute Care Services.51336Specialized Rehabilitative Services in Skilled Nursing Facilities and Intermediate Care Facilities.51337Home Health Agency Services.51338Home Health Aide Services. [Repealed]51339Special Duty Nursing. [Repealed]51340Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services and EPSDT Supplemental Services.51340.1Requirements Applicable to EPSDT Supplemental Services.51341Short-Doyle Mental Health Medi-Cal Program Services.51341.1Drug Medi-Cal Substance Use Disorder Services.51342Acute Administrative Days.51343Intermediate Care Facility Services for the Developmentally Disabled.51343.1Intermediate Care Facility Services for the Developmentally Disabled Habilitative.51343.2Intermediate Care Facility Services for the Developmentally Disabled-Nursing.51344In-Home Medical Care Waiver Services and Nursing Facility Waiver Services.51345Nurse Midwife Services.51345.1Certified Family Nurse Practitioner and Certified Pediatric Nurse Practitioner Services.51346Home and Community-Based Waiver Services.51347Swing Bed Services.51348Comprehensive Perinatal Services.51348.1Comprehensive Perinatal Standards of Care.51348.2Patient Rights.51349Hospice Care.51350Personal Care Services.51351Targeted Case Management Services.51351.1Targeted Case Management Provider Contracts.51355Tuberculosis (TB) Related Services.51356Licensed Midwife Services.51360Local Educational Agency (LEA) Services.51365Targeted Case Management Services Program.