Non-Covered Services

Non-Covered Services A. The Division of Medicaid does not reimburse an RHC for services when performed in an inpatient or outpatient hospital setting. If a physician is employed by an RHC and provides services in a hospital setting, the RHC is prohibited from billing for these services. The physician must bill under the physician’s individual Medicaid provider number or group physician Medicaid provider number. B. The Division of Medicaid does not consider the following as an encounter: 1. Vaccine administration, and/or 2. Diabetes Self-Management Training (DSMT).