The following shall be non-covered services and shall not be eligible for reimbursement:

1. (a) Services not listed in a student’s care plan;
2. (b) Services that are not coverable under the Social Security Act and for which no FFP is available for said service;
3. (c) Services performed by unqualified individuals pursuant to the Social Security Act, or services delivered by provider types not approvable under the Social Security Act to provide medicaid services;
4. (d) Consultations, visits, trainings, meetings, or discussions between healthcare providers or individuals in which the student was not physically present for at least 51% of the time;
5. (e) Services which are non-covered pursuant to He-W 500 and are not covered under EPSDT;
6. (f) Supported employment such as vocational goals and job tasks;
7. (g) Services which are solely educational, remedial education, or vocational instruction or tutoring;

8. (h) Services performed by educators or individuals who are not licensed clinicians such as teachers of the visually impaired or deaf unless:

   1. (1) The individual has a valid license issued by the appropriate licensing board, commission, or council and is acting within the scope of their license;
   2. (2) The individual is a rehabilitative assistant providing rehabilitative assistance services pursuant to He-W 589.04(ak)-(ao); or
   3. (3) The individual currently holds a certification as a BCBA;
9. (i) Leisure and social activities that are non-medical;
10. (j) General supervision of a student as required for any student based on the student’s development and for non-medical reasons;
11. (k) Services that are solely personal care services delivered by a legally responsible family member pursuant to 42 CFR 440.167;
12. (l) Performance of tasks for the sole purpose of assistance with completion of educational assignments;
13. (m) Services under a Centers for Medicare and Medicaid Services (CMS) NH medicaid waiver;
14. (n) Medicaid state plan services only provided under the 1915(i) provisions of the Social Security Act;
15. (o) Day care;
16. (p) Teaching parenting skills;
17. (q) Review of records, documentation development, or report writing;
18. (r) Attending meetings, including individualized education program meetings and IEP team meetings;
19. (s) Parent consultations, contacts, or trainings;

20. (t) School guidance counselor services unless:

    1. (1) The individual has a valid clinical license issued by the appropriate licensing board, commission, or council and is acting within the scope of their license;
    2. (2) The individual is a rehabilitative assistant providing rehabilitative assistance services pursuant to He-W 589.04(ak)-(ao); or
    3. (3) The individual currently holds a certification as a BCBA;
21. (u) Services by individuals not having a current license for the practice specialty area for the service area being provided; and
22. (v) Services requiring the technical or professional skill that a state statute or regulation mandates shall be performed by a clinician licensed or certified by the state.

Source. #4925, INTERIM, eff 8-31-90; ss by #5038, eff 12-28-90; amd by #5132, eff 5-1-91; ss by #5456, eff 9-1-92, EXPIRED: 9-1-98 New. #6861, INTERIM, eff 10-2-98, EXPIRED: 1-30-99 New. #6987, eff 4-27-99; ss by #8874, INTERIM, eff 4-25-07, EXPIRED 10-22-07 New. #9035, eff 11-22-07; amd by #10278, eff 2-23-13; EXPIRED: 11-22-15 in paras. (a), (b)(1)-(7), and (b)(9)-(14); amd by #11045-A, INTERIM, eff 2-25-16, EXPIRES: 8-23-16; ss by #11165, eff 8-23-16; ss by #12607, EMERGENCY RULE, eff 8-20-19, EXPIRED: 2-16-19 (and #11165 effective again pursuant to RSA 541-A:18, V); ss by #12861, EMERGENCY RULE, eff 8-28-19 New. #12994, eff 2-21-20 (formerly He-M 1301.05) (See Revision Note at part heading for He-W 589); ss by #14432, eff 11-25-25, EXPIRES: 11-25-35