ARSD 67:16:03:03. Outpatient hospital services covered

The following outpatient hospital services covered under the medical assistance program are available to eligible individuals: (1) Laboratory services; (2) X ray and other radiology services; (3) Emergency room services; (4) Medical supplies used during treatment at the facility; (5) Physical therapy, speech therapy, and occupational therapy when furnished or supervised by a licensed therapist and periodically reviewed by a physician or other licensed practitioner; (6) Whole blood or packed red cells; (7) Drugs and biologicals which cannot be self-administered; (8) Dialysis treatments; (9) Services of hospital-based physicians or other licensed practitioner; (10) Outpatient surgical procedures, including those procedures covered under the provisions of chapter 67:16:28; (11) Sterilizations authorized under § 67:16:02:09; (12) Hyperbaric oxygen therapy if the requirements listed on the department's prior authorization website are met; and (13) Cardiac rehabilitation - Phase II.