LAC 50:XV.7323. Nonreimbursable Services

A. The following services are not appropriate for personal care and are not reimbursable as EPSDT personal care services: 1. insertion and sterile irrigation of catheters (although changing of a catheter bag is allowable); 2. irrigation of any body cavities which require sterile procedures; 3. application of dressing, involving prescription medication and aseptic techniques, including care of mild, moderate or severe skin problems; 4. administration of injections of fluid into veins, muscles or skin; 5. administration of medicine (an EPSDT PCS direct service worker may only remind/prompt about self-administered medication to an EPSDT eligible beneficiary who is over the age of 18); 6. cleaning of the home in an area not occupied by the beneficiary; 7. laundry, other than that incidental to the care of the beneficiary; 8. shopping for groceries or household items other than items required specifically for the health and maintenance of the beneficiary, and not for items used by the rest of the household; 9. skilled nursing services, as defined in the state Nurse Practices Act, including medical observation, recording of vital signs, teaching of diet and/or administration of medications/injections, or other delegated nursing tasks; 10. teaching a family member or friend how to care for a beneficiary who requires frequent changes of clothing or linens due to total or partial incontinence for which no bowel or bladder training program for the patient is possible; 11. specialized nursing procedures such as: a. insertion of nasogastric feeding tube; b. in-dwelling catheter; c. tracheostomy care; d. colostomy care; e. ileostomy care; f. venipuncture; and/or g. injections; 12. rehabilitative services such as those administered by a physical therapist; 13. teaching a family member or friend techniques for providing specific care; 14. palliative skin care with medicated creams and ointments and/or required routine changes of surgical dressings and/or dressing changes due to chronic conditions; 15. teaching of signs and symptoms of disease process, diet and medications of any new or exacerbated disease process; 16. specialized aide procedures such as: a. rehabilitation of the beneficiary (exercise or performance of simple procedures as an extension of physical therapy services); b. measuring/recording the beneficiary’s vital signs (temperature, pulse, respirations and/or blood pressure, etc.) or intake/output of fluids; c. specimen collection; d. special procedures such as: i. nonsterile dressings; ii. special skin care (nonmedicated); iii. decubitus ulcers;; iv. cast care; v. assisting with ostomy care; vi. assisting with catheter care; vii. testing urine for sugar and acetone; viii. breathing exercises; ix. weight measurement; and x. enemas; 17. home IV therapy; 18. custodial care or provision of only instrumental activities of daily living tasks or provision of only one activity of daily living task; 19. occupational therapy; 20. speech pathology services; 21. audiology services; 22. respiratory therapy; 23. personal comfort items; 24. durable medical equipment; 25. oxygen; 26. orthotic appliances or prosthetic devices; 27. drugs provided through the Louisiana Medicaid pharmacy program; 28. laboratory services; and 29. social worker visits.