R384-200-3. Program Benefits

(1)(a) The Breast and Cervical Cancer Screening and BeWise Programs provide reimbursement to a provider for eligible services to a client. (b) The department provides reimbursement coverage under each program only for the eligible services included in: (i) 42 USC 300k, which establishes the National Breast and Cervical Cancer Early Detection Program (NBCCEDP); and (ii) ongoing CDC program guidance. (3) Within available funding, the department may pay for eligible services under: (a) the Breast and Cervical Cancer Screening Program's Allowable CPT Codes and Reimbursement Rates, 2025 version, incorporated by reference in this rule; and (b) the BeWise Program Allowable CPT Codes and Reimbursement Rates, 2025 version, incorporated by reference in this rule. (4) The Breast and Cervical Cancer Screening Program provides referral for treatment services but does not pay for treatment services. (5) The BeWise program does not pay for treatment services, including medication, medical nutrition therapy, or highly specialized counseling such as a diabetes education program. (6) The department may adjust reimbursed services to meet current needs and depending on available funding. (7) The Breast and Cervical Cancer Screening and BeWise Programs are not health insurance. This rule does not create an insurer-insured relationship between the department and a client.