(a) Covered services under the program may include, but are not necessarily limited to, the following:
- (1) Laboratory services related to a recipient's pregnancy, performed or ordered by a physician, advanced practice registered nurse, or physician assistant.
- (2) Screening and treatment for sexually transmitted disease.
- (3) Prenatal visits to a physician in the physician's office, an advanced practice registered nurse in the advanced practice registered nurse's office, a physician assistant in the physician assistant's office, or to a hospital outpatient prenatal clinic, local health department maternity clinic, or community health center.
- (4) Radiology services which are directly related to the pregnancy, are determined to be medically necessary and are ordered by a physician, an advanced practice registered nurse, or a physician assistant.
- (5) Pharmacy services related to the pregnancy.
- (6) Other medical consultations related to the pregnancy.
- (7) Physician, advanced practice registered nurse, physician assistant, or nurse services associated with delivery.
- (8) One postnatal office visit within 60 days after delivery.
- (9) Two EPSDT-equivalent screenings for the infant within 90 days after birth.
- (10) Social and support services.
- (11) Nutrition services.
- (12) Case management services.
(b) The following services shall not be covered under the program:
- (1) Services determined by the Department not to be medically necessary.
- (2) Services not directly related to the pregnancy, except for the 2 covered EPSDT-equivalent screenings.
- (3) Hospital inpatient services.
- (4) Anesthesiologist and radiologist services during a period of hospital inpatient care.
- (5) Physician, advanced practice registered nurse, and physician assistant hospital visits.
- (6) Services considered investigational or experimental.
(from Ch. 111 1/2, par. 7026)
(Source: P.A. 100-513, eff. 1-1-18.)