Sec. 10.09.06.07. Limitations

Latest version.

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 providers scope of practice;

F. Investigational and experimental drugs and procedures;

G. More than two 30-day spans of care in a 12-month period;

H. Services rendered but not appropriately documented; and

I. Services not preauthorized as required in Regulation .08 of this chapter.

                    
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