Pregnancy-Related Services: Coverage And Limitations

When ordered by the participant's attending provider, payment of the following services is available after confirmation of pregnancy and extending through the end of the month in which the sixtieth day following delivery occurs. (7-1-26) 01. Individual and Family Social Services. Limited to two (2) visits during the covered period. (7-1-26) 02. Maternity Nursing Visit. These services are only available to women unable to obtain a provider to provide prenatal care. This service is to end immediately when a primary physician is found. A maximum of nine (9) visits can be authorized. (7-1-26) 03. Nursing Services. Limited to two (2) visits during the covered period. (7-1-26) 04. Qualified Provider Risk Assessment and Plan of Care. When prior authorized by the Department, payment is made for qualified provider services in completion of a standard risk assessment and plan of care for women unable to obtain a PCP for the provision of antepartum care. (7-1-26) 05. Risk Reduction Follow-Up. (7-1-26) 363. (RESERVED)