048.0037.13.8

Ch. 13, § 8. Excluded Services

Last amended: 2025Length: 253 wordsOfficial source

Cite as Medicaid Rules, Ch. 13, § 8

. (a) The following services are excluded: (i) Clinical services which are not provided in person or via a telehealth modality, other than collateral contacts necessary to develop or implement a treatment plan; (ii) Education, public education, public relations, and speaking engagements; (iii) Day care; (iv) Driving while under the influence (DUI) classes; (v) Missed appointments; (vi) Psychological testing done for the sole purpose of education diagnosis, school or institution admission or placement or Medicaid waiver eligibility assessments; (vii) Record-keeping time, unless allowed by a specific service code; (viii) Recreation and socialization without an active clinical treatment component as specified in the individual client's treatment plan; (ix) Remedial or other formal education; (x) Residential room, board, or care; (xi) Substance abuse or mental health disorder prevention services; (xii) Support groups, such as Alcoholics Anonymous or Narcotics Anonymous; (xiii) Time spent preparing records or reports, except for up to three (3) hours for a licensed psychologist to prepare a formal report of test findings; (xiv) Vocational services; (xv) Services provided to a client with: (A) Sole Diagnostic and Statistical Manual (DSM) diagnosis of intellectual or cognitive disability; (B) DSM diagnosis of factitious disorder; or (C) DSM diagnosis of any ICD-10 "Z" code, unless the client's medical record contains a written statement signed by the affiliated clinical professional explaining why the treatment of a condition that is not classified as a mental disorder is medically necessary; (xvi) Services provided by a school psychologist, except when provided pursuant to Medicaid Rules Chapter 52 School Based Services.
048.0037.13.8: Ch. 13, § 8. Excluded Services | Justis AI