Services covered under this chapter are limited to services that meet the following criteria:

1. (1) Medically necessary services covered under chapters 67:16:01, 67:16:02, 67:16:06, 67:16:11, 67:16:12, 67:16:41, and 67:16:48;
2. (2) Provided to a recipient at a federally qualified health center, rural health clinic, or other outpatient setting, including the recipient's place of residence or a skilled nursing facility. Services provided at an inpatient or outpatient hospital are not covered; and

3. (3) Provided under the medical direction of a physician.

   Cross-References:

   Scope of benefits - Clinic, 42 C.F.R. § 405.2411.

   Scope of services - Center, 42 C.F.R. § 405.2446.

Source: 23 SDR 109, effective January 5, 1997; 26 SDR 168, effective July 1, 2000; 37 SDR 53, effective September 23, 2010; 46 SDR 50, effective October 10, 2019.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1 (1)(2) .

Prior versions effective: 2010-09-23.