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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC5. MEDICAID SERVICES |
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Rule 405IAC5-21.7. Child Mental Health Wraparound Services |
Section 405IAC5-21.7-15. Services: general provisions
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(a) All CMHW services provided to a member must meet the following requirements:
(1) Be supported by the member's level of need.
(2) Be documented in the member's plan of care.
(b) A provider shall maintain documentation for services provided to a CMHW services member in accordance with the requirements under 405 IAC 1-5-1.
(c) Provider reimbursement for CMHW services is subject to, but not limited to, the following:
(1) The member's eligibility for services.
(2) The provider's qualifications and certification.
(3) Prior authorization by the office.
(4) The scope, limitations, and exclusions of the services.
(Office of the Secretary of Family and Social Services; 405 IAC 5-21.7-15; filed Dec 18, 2013, 11:13 a.m.: 20140115-IR-405130211FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)