Manual Archive

Chapter 100 - General Information Effective September 1, 2003 and revised January 1, 2005
Chapter 200 - Definitions Effective September 1, 2003
Chapter 300 - Provider Participation Requirements Effective September 1, 2003 and revised March 1, 2007

Chapter 400 Member Eligibility Effective December 1, 2015
Chapter 400 Public Comments and Responses Effective December 1, 2015
Chapter 400 - Member Eligibility Effective October 1, 2003 and revised January 1, 2005

Chapter 500 - Lab and Radiology Effective July 1, 2004 and revised January 1, 2005

Chapter 501 - Aged & Disabled Waiver Effective November 1, 2003 and revised January 1, 2008
Chapter 501 - Aged & Disabled Waiver Effective September 1, 2011 and revised June 1, 2014

Chapter 502 - Behavioral Health Clinic Effective July 1, 2004 and revised January 1, 2006
Chapter 502 - Behavioral Health Clinic Effective July 1, 2014

Chapter 502 - Behavioral Health Clinic Replaced by Chapter 503 - Licensed Behavioral Health Center Services Effective July 15, 2018

Chapter 503 - Behavioral Health Rehabilitation Effective July 1, 2004 and revised January 1, 2006
Chapter 503 - Behavioral Health Rehabilitation Effective July 1, 2014

Chapter 503 - Behavioral Health Rehabilitation Replaced by Chapter 503 - Licensed Behavioral Health Center Services Effective July 15, 2018

Chapter 504 - Substance Use Disorder Services  Effective January 14, 2018
Chapter 504 - Substance Use Disorder Services Public Comments and Answers  Effective January 14, 2018
Chapter 504 Public Comments and Answers Effective July 1, 2018
Chapter 504 - Chiropractic Services  Effective October 1, 2005

Chapter 505 - Dental Services Effective November 1, 2010
Chapter 505 - Dental Services Effective January 16, 2012
Chapter 505 - Dental Services Effective May 25, 2016
Chapter 505 Oral Health Services  Effective October 1, 2019
Appendix  505A Oral Health Services for Children Under Age 21 Effective January 1, 2020

Chapter 506 - DME/Medical Supplies  Effective May 1, 2005 and revised January 1, 2008
     Appendix 506A Covered DME Supplies Effective October 1, 2015 to January 1, 2016
     Appendix 506B Covered O and P Supplies Effective October 1, 2015 to January 1, 2016
     Appendix 506C Non-covered DMEPOS Supplies Effective October 1, 2015 to January 1, 2016

 

Chapter 507 - ASC & Birthing Centers Effective June 1, 2005 revised February 15, 2006

Chapter 508 - Home Health  Effective July 1, 2004 and last revised on July 1, 2010

Chapter 509 - Hospice Services July 1, 2004
Chapter 509 - Hospice Services May 1, 2014

Chapter 510 - Hospital Services Effective July 1, 2004 and revised on January 12, 2006

Chapter 511 - ICF/MR Services Effective July 1, 2004

Chapter 512 - Traumatic Brain Injury Waiver Effective February 1, 2012 and revised Feb 1, 2013

Chapter 513 - IDD Waiver Services Effective October 1, 2011
Chapter 513 - IDD Waiver Services Effective November 1, 2007
Chapter 513 - MR/DD Waiver Services Effective December 1, 2004 and revised January 1, 2009

Chapter 514 - Nursing Facility Services Effective January 1, 2005 and revised April 10, 2010

Chapter 515 - Occupational/Physical Therapy Effective July 1, 2004 and revised May 1, 2005

Chapter 516 - Orthotic & Prosthetic Services Effective March 1, 2007 and revised January 1, 2008

Chapter 517 - Personal Care Effective January 1, 2014

Chapter 518 - Pharmacy Services Effective April 17, 2006 and revised November 1, 2010
Chapter 518 - Pharmacy Services Effective January 1, 2010 to November 1, 2013
Chapter 518 Pharmacy Services Effective July 20, 2018
Chapter 518A Physician Administered Drugs Effective July 20, 2018

Chapter 519 - Practitioner Services  July 1, 2005 and revised January 16, 2012
  Policy 519.7 Chiropractic Services      Effective January 15, 2016
  Policy 519.15   Reproductive Health Services Effective January 15, 2016
  Policy 519.17 Telehealth Services Effective January 15, 2016
  Policy 519.18 Tobacco Cessation Services Effective January 15, 2016
  Policy 519.19 Women's Health Services Effective August 30, 2019
  Policy 519.23 Applied Behavior Analysis  Effective September 1, 2018
  Policy 519.23 Applied Behavior Analysis Public Comments and Answers  Effective September 1, 2018
  Policy 519.3 Antigen and Allergy Services Valid January 15, 2016 to February 19, 2016

Chapter 520 - Podiatry Services  Effective July 1, 2004 and revised February 15, 2006

Chapter 521 - Psychological Services Effective September 1, 2003 and revised January 1, 2006

Chapter 522 - RHC FQHC Services Effective July 1, 2004
Chapter 522 - FQHCRHC Services Effective December 1, 2015
Chapter 522 - FQHCRHC Public Comments and Responses Effective December 1, 2015

Chapter 523 - Targeted Case Management Effective May 1, 2004 and revised January 1, 2006

Chapter 524 - Transportation  Effective September 1, 2003 and revised September 15, 2005
Chapter 524 - Transportation  Effective September 18, 2015

Chapter 525 - Vision Services Effective September 1, 2003 and revised April 14, 2006
Chapter 525 - Vision Services Effective October 1, 2015

Chapter 526 - Children with Disabilities Community Services Program (CDCSP)  September 1, 2008

Chapter 527 - Mountain Health Choices Effective January 30,2009 and Retired September 2011
Chapter 527 Mountain Health Trust (Managed Care) Effective April 1, 2018
Chapter 527 Public Comments and Answers Effective April 1, 2018

Chapter 528 - Radiology Services Effective January 1, 2010
     Radiology Services Requiring Prior Authorization Effective January 1, 2013
     Policy 528.4 Mammography Effective April 24, 2019

Chapter 529 - Laboratory Services Effective January 1, 2010
     Laboratory Services regarding prior authorization Effective August 5, 2013
     Policy 529.2 Drug Screenings Effective January 1, 2017
     Policy 529.2 Drug Screenings Public Comments Effective January 1, 2017

Chapter 530 - Speech and Audiology Services Effective January 1, 2012

Chapter 531 - Psychiatric Residential Treatment Facility Services Effective May 1, 2013

Chapter 532 - Private Duty Nursing Effective December 21, 2016
Chapter 532 - Private Duty Nursing Effective September 1, 2012
Chapter 532 - Private Duty Nursing Effective September 15, 2015
Chapter 532 - Private Duty Nursing Program Instruction January 1, 2000

Chapter 537 - Licensed Independent Clinical Social Worker (LICSW) Effective January 15, 2018

Chapter 538 - School Based Health Services  Effective August 1, 2015 to August 1, 2017
Chapter 538 - School-Based Health Services Public Comments and Answers  Effective August 1, 2015
Chapter 538 School Based Health Services  Effective August 1, 2017
Chapter 538 Public Comments and Responses Effective August 1, 2017
   Appendix 538A     Nursing Billing Form Effective August 1, 2015
   Appendix 538B     Audiological Billing Form Effective August 1, 2015
   Appendix 538C     Speech Therapy Billing Form  Effective August 1, 2015
   Appendix 538D     Psychological Billing Form Effective August 1, 2015
   Appendix 538E     Personal Care Medicaid Log Effective August 1, 2015
   Appendix 538F     Occupational Therapy Billing Form Effective August 1, 2015
   Appendix 538G     Physical Therapy Billing Form Effective August 1, 2015
   Appendix 538H     Targeted Case Management Form Effective August 1, 2015
   Appendix 538I       Transportation Billing Form Effective August 1, 2015

Chapter 600 - Reimbursement Methodologies Effective September 1, 2003 and revised January 1, 2006

Chapter 800 - General Administration Effective January 1, 2009

Chapter 800B - Quality and Program Integrity Effective December 1, 2012

Chapter 900 - Estate Recovery Effective July 2008

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