Sec. 10.09.42.04. Covered Services

Latest version.

The Program covers the following:

A. Medically necessary facility services rendered to recipients in a free-standing Medicare-certified ambulatory surgical center;

B. Diagnostic, curative, palliative, or rehabilitative services, when clearly related to the recipient's individual needs;

C. Surgical procedures which meet the standards described in 42 CFR Part 416, Subpart D, §416.65, and as published by the Centers for Medicare and Medicaid Services; and

D. Dental services that have been pre-authorized by the Dental Benefits Administrator (DBA).

                    
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