- 1. Chiropractor services.
- 2. Private duty nursing services, unless an individual receives services under Early and Periodic Screening, Diagnosis, and Treatment Services or a § 1915(c) Waiver.
- 3. Dentures.
- 4. Diagnostic or preventive services other than those provided elsewhere in the State Plan.
- 5. Inpatient hospital services, skilled nursing facility services, and intermediate care facility services for individuals 65 years of age or older in institutions for mental diseases.
- 6. Intermediate care facility services (other than such services in an institution for mental diseases) for persons determined in accordance with § 1905(a)(4)(A) of the Social Security Act (the Act), to be in need of such care in a public institution, or a distinct part thereof, for persons with intellectual or developmental disability or related conditions.
- 7. (Reserved.)
- 8. Special tuberculosis services under § 1902(z)(2)(F) of the Act.
- 9. Respiratory care services in accordance with § 1920(e)(9)(A) through (C) of the Act.
- 10. Ambulatory prenatal care for pregnant women furnished during a presumptive eligibility period by a qualified provider in accordance with § 1920 of the Act.
- 11. Personal care services in a recipient's home, prescribed in accordance with a plan of treatment and provided by a qualified person under supervision of a registered nurse.
- 12. Home and community care for functionally disabled elderly individuals.
- 13. Personal care services furnished to an individual who is not an inpatient or resident of a hospital, nursing facility, intermediate care facility for intellectually or developmentally disabled persons, or institution for mental disease that are (i) authorized for the individual by a physician in accordance with a plan of treatment, (ii) provided by an individual who is qualified to provide such services and who is not a member of the individual's family, and (iii) furnished in a home.
The following services and devices shall not be provided to the medically needy:
Statutory Authority
§ 32.1-325 of the Code of Virginia, 42 USC § 1396 et seq.
Historical Notes
Derived from VR460-03-3.1200, eff. June 16, 1993; amended, Virginia Register Volume 12, Issue 2, eff. November 15, 1995; Volume 12, Issue 3, eff. November 29, 1995; Volume 14, Issue 18, eff. July 1, 1998; Volume 17, Issue 5, eff. January 1, 2001; Volume 18, Issue 7, eff. January 16, 2002; Volume 35, Issue 24, eff. August 22, 2019; Volume 41, Issue 19, eff. June 19, 2025; Volume 42, Issue 13, eff. March 26, 2026.