Amount, Duration, and Scope of Services | MidpageAmount, Duration, and Scope of Services
100Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; enrolled providers.105Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; nonenrolled providers (nonparticipating/out of state).110Outpatient hospital and rural health clinic services.120Other laboratory and x-ray services.130Nursing facility services, EPSDT, including school health services and family planning.131Services provided by certified Early Intervention practitioners under EPSDT.132Private duty nursing services under early and periodic screening, diagnostic, and treatment.140Physician's services whether furnished in the office, the patient's home, a hospital, a skilled nursing facility, or elsewhere.150Medical care by other licensed practitioners within the scope of their practice as defined by state law.160Home health services.165Durable medical equipment suitable for use in the home.170Private duty nursing services.180Clinic services.190Dental services.200Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders.210Prescribed drugs, dentures, and prosthetic devices, and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist.220Diagnostic, screening, preventive, and rehabilitative services other than those provided elsewhere in this plan.225Rehabilitative services; intensive physical rehabilitation, and CORF services.226Community mental health services.227Lead contamination.229[Reserved]. (Reserved)230Services for individuals age 65 or older in institutions for mental diseases.240Intermediate care services and intermediate care services for institutions for mental disease and intellectual disabilities.250Inpatient psychiatric facility services for individuals under 21 years of age.260Nurse-midwife services.270Hospice services (in accordance with § 1905 (o) of the Act).280Case management services for high-risk pregnant women and children up to age 1, as defined in 12VAC30-50-410, in accordance with § 1915 (g)(1) of ....290Extended services to pregnant women.300Any other medical care and any other type of remedial care recognized under state law, specified by the Secretary of Health and Human Services.310Emergency services for aliens.320Program of All-Inclusive Care for the Elderly (PACE).321Eligibility for PACE enrollees.325Rates and payments.328PACE enrollment and disenrollment.330PACE definitions.335General PACE plan requirements.340Criteria for PACE enrollment.345PACE enrollee rights.350PACE enrollee responsibilities.355PACE plan contract requirements and standards.360PACE sanctions.