048.0037.51.7
Ch. 51, § 7. Basic Level of Benefits
Cite as Medicaid Rules, Ch. 51, § 7
(a) The covered services provided to CHIP clients, at a minimum, shall include the following services:
(i) Inpatient hospital services;
(ii) Outpatient hospital services;
(iii) Physician services;
(iv) Surgical services;
(v) Clinic services and other ambulatory health care services;
(vi) Prescription drugs;
(vii) Laboratory and radiological services;
(viii) Prenatal care and pre-pregnancy family planning services and supplies;
(ix) Inpatient mental health services;
(x) Outpatient mental health services;
(xi) Durable medical equipment, prosthetics and orthotics;
(xii) Abortion, only if necessary to save the life of the mother or if the pregnancy is the result of rape or incest;
(xiii) Dental services;
(xiv) Medically necessary orthodontia;
(xv) Inpatient substance abuse treatment services;
(xvi) Outpatient substance abuse treatment services;
(xvii) Preventive care, screening and immunization;
(xviii) Hospice care;
(xix) Emergency medical transportation where care is administered during transportation;
(xx) Vision services;
(xxi) Dietician services;
(xxii) Hearing services;
(xxiii) Home health services;
(xxiv) Interpretation services;
(xxv) Nurse practitioner and nurse midwife services;
(xxvi) Organ transplant services;
(xxvii) Occupational, physical and speech therapy services;
(xxviii) Rehabilitation services;
(xxix) Non-emergency medical transportation services; and
(xxx) Any other services determined to be medically necessary as defined in Medicaid Rules Chapter 1.
(b) No exclusion for pre-existing conditions or a maximum life-time benefit per client shall be imposed under CHIP.