Regulation .07 Limitations.
Regulation .07 Limitations.LinkCopy Citation
The Program does not cover the following in a residential substance use disorder treatment facility for adults:
A.
Services not medically necessary;
B.
ASAM Level 2 services by any provider;
C.
Except for services rendered to individuals in a residential, low-intensity program, ASAM Level 1 services by any provider;
D.
Services not specified in Regulation .06 of this chapter;
E.
Services beyond the provider’s scope of practice;
F.
Investigational and experimental drugs and procedures;
G.
Services rendered but not appropriately documented; and
H.
Services not preauthorized as required in Regulation .08 of this chapter.
I.
Additional services rendered via telehealth when telehealth services comprise more than 50 percent of a participant's weekly clinical services.