(a) Payment will not be made for the following:
- (1) Screens that do not include the appropriate tests in Appendix A (relating to screening services required examinations and diagnostic tests).
- (2) General health care provided during an EPSDT screening examination visit.
- (3) A medical examination performed on the same day as the screen.
- (4) Invoices not submitted to the billing contractor within 30 days of the screening examination. Invoices received after 30 days will be returned.
- (5) Laboratory tests that are included in the screening fee.
(b) The following services and items are noncompensable for medically needy screened individuals:
- (1) Medical equipment and supplies, with the exception of hearing aids and eyeglasses.
- (2) Prostheses.
- (3) Appliances.
- (4) Orthoses.
- (5) Pharmaceutical services as specified in Chapter 1121 (relating to pharmaceutical services).
Source
The provisions of this § 1241.54 adopted December 6, 1980, effective December 1, 1980, 10 Pa.B. 4611.