405 IAC 1-11.5-1
405 IAC 1-11.5-1 Policy; scope
Cite as Ind. Admin. Code tit. 405, r. 1-11.5-1
Sec. 1. (a) Reimbursement for physician services, limited license practitioner services, and nonphysician practitioner services, as defined
by 42 CFR 440.50 and 42 CFR 440.60(a), is available to providers licensed by the professional licensing agency and enrolled by the office as
providers who are in good standing. Continued participation in Medicaid and payment for services is contingent on maintaining state licensure and
conformance with the office's provider agreement.
(b) As used in this rule, "physician and limited license practitioner" or "LLP" means any of the following:
(1) A doctor of medicine.
(2) A doctor of osteopathy.
(3) A physician group practice.
(4) A primary care group practice.
(5) An optometrist.
(6) A podiatrist.
(7) A dentist who is an oral surgeon.
(8) A chiropractor.
(9) A health service provider in psychology.
(c) As used in this rule, "nonphysician practitioner" or "NPP" means any of the following:
(1) A physical therapist.
(2) An occupational therapist.
(3) A respiratory therapist.
(4) An audiologist.
(5) A speech therapist.
(6) A licensed psychologist.
(7) An independent laboratory or radiology provider.
(8) A dentist who is not an oral surgeon.
(9) A social worker certified through the American Academy of Certified Social Workers or who has a master of social work degree,
a psychologist with a basic certificate, or a licensed psychologist providing outpatient mental health services in a physician-directed outpatient mental
health facility.
(10) An advanced practice nurse.
(11) A physician assistant.
(12) A mental health professional listed in 405 IAC 5-21.5-1(c), or an individual who has documented education, training,
or experience, comparable or equivalent to those listed in this subsection, as approved by the supervising physician or health service provider in
psychology (HSPP), under the supervision of a psychiatrist, physician, or licensed psychologist or psychologist endorsed as an HSPP.
(13) An inpatient hospital facility as defined in 405 IAC 1-10.5-2.
(14) A licensed pharmacist.