Chapter 50. Amount, Duration, and Scope of Medical and Remedial Care ServicesRead Chapter
- Part I. Categorically NeedyRead all
- Section 10
- Services provided to the categorically needy with limitations
- Section 20
- Services provided to the categorically needy without limitation
- Section 30
- Services not provided to the categorically needy
- Section 35
- Requirements relating to payment for covered outpatient drugs for the categorically needy
- Part II. Ambulatory Services; Medically NeedyRead all
- Section 40
- Ambulatory services
- Section 50
- Services provided to the medically needy with limitations
- Section 60
- Services provided to all medically needy groups without limitations
- Section 70
- Services or devices not provided to the medically needy
- Section 75
- Requirements relating to payment for covered outpatient drugs for the medically needy
- Section 80
- [Reserved]
- Section 95
- Reimbursement of services; in general
- Part III. Amount, Duration, and Scope of ServicesRead all
- Section 100
- Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; enrolled providers
- Section 105
- Inpatient hospital services provided at general acute care hospitals and freestanding psychiatric hospitals; nonenrolled providers (nonparticipating/out of state)
- Section 110
- Outpatient hospital and rural health clinic services
- Section 120
- Other laboratory and x-ray services
- Section 130
- Nursing facility services, EPSDT, including school health services and family planning
- Section 131
- Services provided by certified Early Intervention practitioners under EPSDT
- Section 140
- Physician's services whether furnished in the office, the patient's home, a hospital, a skilled nursing facility, or elsewhere
- Section 150
- Medical care by other licensed practitioners within the scope of their practice as defined by state law
- Section 160
- Home health services
- Section 165
- Durable medical equipment suitable for use in the home
- Section 170
- Private duty nursing services
- Section 180
- Clinic services
- Section 190
- Dental services
- Section 200
- Physical therapy, occupational therapy, and services for individuals with speech, hearing, and language disorders
- Section 210
- Prescribed drugs, dentures, and prosthetic devices, and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist
- Section 220
- Diagnostic, screening, preventive, and rehabilitative services other than those provided elsewhere in this plan
- Section 225
- Rehabilitative services; intensive physical rehabilitation, and CORF services
- Section 226
- Community mental health services
- Section 227
- Lead contamination
- Section 228
- [Repealed]
- Section 229
- [Reserved]
- Section 229.1
- [Repealed]
- Section 230
- Services for individuals age 65 or older in institutions for mental diseases
- Section 240
- Intermediate care services and intermediate care services for institutions for mental disease and mental retardation
- Section 250
- Inpatient psychiatric facility services for individuals under 21 years of age
- Section 260
- Nurse-midwife services
- Section 270
- Hospice services (in accordance with § 1905 (o) of the Act)
- Section 280
- Case management services for high-risk pregnant women and children up to age 1, as defined in 12VAC30-50-410, in accordance with § 1915 (g)(1) of ...
- Section 290
- Extended services to pregnant women
- Section 300
- Any other medical care and any other type of remedial care recognized under state law, specified by the Secretary of Health and Human Services
- Section 310
- Emergency services for aliens
- Section 320
- Program of All-Inclusive Care for the Elderly (PACE)
- Section 321
- Eligibility for PACE enrollees
- Section 325
- Rates and payments
- Section 328
- PACE enrollment and disenrollment
- Section 330
- PACE definitions
- Section 335
- General PACE plan requirements
- Section 340
- Criteria for PACE enrollment
- Section 345
- PACE enrollee rights
- Section 350
- PACE enrollee responsibilities
- Section 355
- PACE plan contract requirements and standards
- Section 360
- PACE sanctions
- Part IV. Case Management ServicesRead all
- Section 410
- Case management services for high risk pregnant women and children
- Section 415
- Case management for individuals receiving early intervention (Part C) services
- Section 420
- Case management services for seriously mentally ill adults and emotionally disturbed children
- Section 430
- Case management services for youth at risk of serious emotional disturbance
- Section 440
- Support coordination/case management services for individuals with intellectual disability
- Section 450
- [Repealed]
- Section 460
- [Repealed]
- Section 470
- Case management for recipients of auxiliary grants
- Section 480
- Case management for foster care children
- Section 490
- Support coordination/case management for individuals with developmental disabilities
- Section 491
- Substance use case management services for individuals who have a primary diagnosis of substance use disorder
- Part V. Expanded Prenatal Care ServicesRead all
- Section 510
- Requirements and limits applicable to specific services: expanded prenatal care services
- Part VI. Drugs or Drug CategoriesRead all
- Section 520
- Drugs or drug categories which are not covered
- Part VII. TransportationRead all
- Section 530
- Methods of providing transportation
- Part VIII. Organ Transplant ServicesRead all
- Section 540
- Kidney transplantation (KT)
- Section 550
- Corneal transplantation
- Section 560
- Liver, heart, lung, allogeneic and autologous bone marrow transplantation
- Section 570
- High dose chemotherapy and bone marrow/stem cell transplantation (coverage for persons over 21 years of age)
- Section 580
- Other medically necessary transplantation procedures that are determined to not be experimental or investigational (coverage for persons younger ...
- Part IX. Commonwealth Coordinated Care Program [Repealed]Read all
- Section 600
- [Repealed]
- Part X. Alternative Benefit PlanRead all
- Section 610
- Alternative benefit plan: Medicaid expansion