(a) Covered services under the program may include, but are not necessarily limited
to, the following:
(1) Laboratory services related to a recipient's pregnancy, performed or ordered by
a physician, advanced practice registered nurse, or physician assistant.
(2) Screening and treatment for sexually transmitted disease.
(3) Prenatal visits to a physician in the physician's office, an advanced practice
registered nurse in the advanced practice registered nurse's office, a physician assistant
in the physician assistant's office, or to a hospital outpatient prenatal clinic,
local health department maternity clinic, or community health center.
(4) Radiology services which are directly related to the pregnancy, are determined
to be medically necessary and are ordered by a physician, an advanced practice registered
nurse, or a physician assistant.
(5) Pharmacy services related to the pregnancy.
(6) Other medical consultations related to the pregnancy.
(7) Physician, advanced practice registered nurse, physician assistant, or nurse services
associated with delivery.
(8) One postnatal office visit within 60 days after delivery.
(9) Two EPSDT-equivalent screenings for the infant within 90 days after birth.
(10) Social and support services.
(11) Nutrition services.
(12) Case management services.
(b) The following services shall not be covered under the program:
(1) Services determined by the Department not to be medically necessary.
(2) Services not directly related to the pregnancy, except for the 2 covered EPSDT-equivalent
(3) Hospital inpatient services.
(4) Anesthesiologist and radiologist services during a period of hospital inpatient
(5) Physician, advanced practice registered nurse, and physician assistant hospital
(6) Services considered investigational or experimental.
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
Was this helpful?
Response sent, thank you
Welcome to FindLaw's Cases & Codes
A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.