Authority: IC 12-17.6-2-11

Affected: IC 12-17.6

Sec. 1. (a) The following services will be covered by CHIP using the same coverage criteria, limitations, and procedures, including prior authorization, as Medicaid under rules adopted by the secretary at 405 IAC 5 unless a service is listed as noncovered in 407 IAC 3-13 [ 405 IAC 13-12]:

1. (1) Physician services, except that office visits shall be reimbursed in accordance with 407 IAC 3-5-1 [ 405 IAC 13-4-1].
2. (2) Inpatient hospital, except that inpatient rehabilitation services are limited to fifty (50) days per calendar year.
3. (3) Outpatient hospital.
4. (4) Laboratory and radiology.
5. (5) Certified nurse practitioner.
6. (6) Family planning services and supplies.
7. (7) Certified nurse-midwife.
8. (8) Vision.
9. (9) Home health and clinic services.
10. (10) Dental.
11. (11) Hospice.
12. (12) Diabetes self-management training.
13. (13) Food supplements, nutritional supplements, and infant formulas.
14. (14) Restricted utilization.
15. (15) Consultations and second opinions.
16. (16) Anesthesia.

(b) The following services will be covered by CHIP using the coverage criteria, limitations, and procedures described in 407 IAC 3-4 [ 405 IAC 13-3] through 407 IAC 3-12 [ 405 IAC 13-11]:

1. (1) Early intervention services.
2. (2) Evaluation and management services.
3. (3) Medical supplies and equipment.
4. (4) Mental health and substance abuse services.
5. (5) Therapy services.
6. (6) Transportation.
7. (7) Pharmacy services.
8. (8) Podiatry services.
9. (9) Chiropractic services.

(Office of the Secretary of Family and Social Services; 405 IAC 13-2-1; filed May 3, 2000, 2:02 p.m.: 23 IR 2235; readopted filed May 22, 2006, 3:22 p.m.: 29 IR 3424; readopted filed Jun 18, 2012, 11:23 a.m.: 20120718-IR-407120202RFA; readopted filed Apr 9, 2018, 9:12 a.m.: 20180509-IR-405180110RFA; readopted filed Oct 16, 2024, 11:20 a.m.: 20241113-IR- 405230817RFA) NOTE: Transferred from the Office of the Children's Health Insurance Program ( 407 IAC 3-3-1) to the Office of the Secretary of Family and Social Services ( 405 IAC 13-2-1) by P.L.35-2016, SECTION 53, effective March 21, 2016.