Sec. 10.09.57.04. Covered Services

Providers may be capitated for one of the following packages of services subject to the approval of the Department:

A. Inpatient hospital services, as long as the applicant, if regulated by the Health Services Cost Review Commission, has received permission from that agency to receive capitation payments;

B. Mental health services, including but not limited to, psychiatric inpatient treatment and community mental health outpatient services;

C. Not more than two of the following services or groups of services:

(1) Outpatient hospital services,

(2) Physician services,

(3) Laboratory and X-ray services,

(4) Nursing facility services, EPSDT, and family planning services, and

(5) Home health services;

D. Any service covered by the Program other than a service specified in §A or C of this regulation;

E. Inpatient hospital services as listed in §A of this regulation, plus one or more of the services included in §D of this regulation; or

F. Not more than two of the services listed in §C of this regulation, plus one or more of the services included in §D of this regulation.