ARSD 67:16:02:04. Physician's services covered

Physician's services covered are limited to the following professional services, which must be medically necessary and provided by a physician or other licensed practitioner to a recipient: (1) Medical and surgical services; (2) Services and supplies furnished incidental to the professional services of a physician or other licensed practitioner; (3) Psychiatric services; (4) Drugs and biologicals administered in a physician or other licensed practitioner's office which cannot be self-administered; (5) Routine physical examinations; (6) Routine visits to a nursing facility, a home and community-based service provider, an intermediate care facility for individuals with intellectual disabilities, or a home and community-based waiver service provider; (7) Cosmetic surgery when incidental to prompt repair following an accidental injury or for the improvement of the functioning of a malformed body member; (8) Family planning services; (9) Pap smears; (10) Dialysis treatments; (11) Hysterectomies as authorized under 42 C.F.R. §§ 441.250 to 441.259, inclusive, as amended to April 1, 2017; and (12) Hyperbaric oxygen therapy if the requirements listed on the department's prior authorization website are met.