67 : 16 : 48 : 03 . Services not covered. The following services are not covered under the provisions of this chapter:

1. (1) Treatment for a diagnosis of substance use disorder that exceeds the limits established by the division, unless prior authorization is approved by the division;
2. (2) Out-of-state substance use disorder treatment unless the division determines that appropriate in-state treatment is not available;
3. (3) Treatment for a gambling disorder;
4. (4) Room and board for residential services;
5. (5) Substance use disorder treatment before the integrated assessment is completed;
6. (6) Substance use disorder treatment after 30 days if the treatment plan has not been completed;
7. (7) Substance use disorder treatment if a required review has not been completed;
8. (8) Court appearances, staffing sessions, or treatment team appearances; and
9. (9) Substance use disorder services provided to a recipient incarcerated in a correctional facility.

Source: 43 SDR 80 , effective December 5, 2016 ; 44 SDR 192, effective July 2, 2018.

General Authority: SDCL 28 - 6 - 1(1)(4).

Law Implemented: SDCL 28-6-1 (1)(4) .

Prior versions effective: 2016-12-05.