R414-140-5. Service Coverage

A health plan shall provide each medically necessary service covered under the Utah Medicaid State Plan, except: (1) apnea monitors; (2) applied behavioral analysis services; (3) care in a nursing facility, intermediate care facility, or long-term acute care hospital for longer than 30 days; (4) chiropractic services; (5) dental services; (6) early intervention services; (7) mental health evaluations and psychological testing performed for physical health purposes; (8) methadone maintenance treatment services; (9) psychological evaluations and testing; (10) school-based skills development program services; (11) services performed at the Utah State Developmental Center; (12) services performed at the Utah State Hospital; (13) services provided by an Indian health services facility, tribal facility, or urban Indian organization facility; (14) specialized mental health services; (15) specific classes of drugs, including for mental health and substance use disorder treatment; (16) substance use disorder services; (17) targeted case management; (18) transportation services; (19) ultra high-cost drugs; and (20) waiver services.