405 IAC 5-21.7-15
405 IAC 5-21.7-15 Services: general provisions
Cite as Ind. Admin. Code tit. 405, r. 5-21.7-15
Sec. 15. (a) All CMHW services provided to a member must meet the following requirements:
(1) Be supported by the member's level of need.
(2) Be documented in the member's plan of care.
(b) A provider shall maintain documentation for services provided to a CMHW services member in accordance with the requirements under
405 IAC 1-5-1.
(c) Provider reimbursement for CMHW services is subject to, but not limited to, the following:
(1) The member's eligibility for services.
(2) The provider's qualifications and certification.
(3) Prior authorization by the office.
(4) The scope, limitations, and exclusions of the services.