1. A. Medicaid reimbursement is limited to medically necessary services that are covered by the Medicaid State Plan and would be covered if furnished by a physician. The following services shall be covered:

   1. 1. services furnished by a physician, within the scope of practice of his profession under Louisiana law;

   2. 2. services furnished by a:

      1. a. physician assistant;
      2. b. nurse practitioner;
      3. c. nurse midwife;
      4. d. clinical social worker;
      5. e. clinical psychologist; or
      6. f. dentist;
   3. 3. services and supplies that are furnished as an incident to professional services furnished by all eligible professionals;
   4. 4. other ambulatory services; and
   5. 5. diabetes self-management training (DSMT) services.
2. B. The department shall provide coverage of diabetes self-management training services rendered to Medicaid beneficiaries diagnosed with diabetes mellitus.
3. C. The department shall provide coverage for fluoride varnish applications performed in the RHC.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 32:1905 (October 2006), repromulgated LR 32:2267 (December 2006), amended by the Department of Health and Hospitals, Bureau of Health Services Financing, LR 37:2631 (September 2011), LR 40:83 (January 2014), amended by the Department of Health, Bureau of Health Services Financing, LR 42:1524 (September 2016), LR 47:50 (January 2021).