Medicaid-manuals.dhhs.utah.gov
Home Health Services
WebHome health services are medically necessary, part-time, intermittent health care services provided to eligible members in settings defined by 42 CFR Part 440.70 when they are medically necessary, cost-effective, and consistent with the member’s medical need.
Actived: 5 days ago
URL: https://medicaid-manuals.dhhs.utah.gov/Home_Health/home_health_services.htm
Physical and Occupational Therapy Services
WebPhysical therapy and occupational therapy services are mandatory for individuals under the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Physical therapy and occupational therapy as described in this manual are a benefit of the Utah Medicaid Program. Physical therapy services must be provided by a licensed therapist.
Early and Periodic Screening, Diagnostic and Treatment Services
WebThe Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, formerly known as Child Health Evaluation and Care (CHEC), is federally mandated, provides comprehensive and preventive health care services for children, and is an integral part of the Medicaid program. Medicaid members who are enrolled in Traditional Medicaid age
Section 1 Genereal Information
WebSection 1 - General information applicable to all providers. It provides general information about the Utah Medicaid Program to assist enrolled providers with submitting claims for services rendered to Utah Medicaid members. Section 1 contains information common to all provider types, including eligibility, covered services, provider enrollment
Medical Supplies and DME
WebRequirements for Obtaining Medical Supplies or DME. Orders for equipment or supplies require: documentation supporting medical necessity maintained in the member's medical records. submission of documentation for PA. a physician's order including the following information: member's name. date of the order.
Target Case Management for Serious Mental Illness
Webthe Department of Health and Human Services; or. a program providing Medicaid-covered services, including targeted case management services for individuals with serious mental illness, under the authority of 1915 (a) of the Social Security Act (i.e., HOME). Providers authorized under Section 1915 (a) of the Social Security Act provide targeted
Personal Care Services
WebEmployment-related Personal Assistant Services (EPAS) is an optional Utah Medicaid program authorized by Section 1905 (a) (24) of the Social Security Act. Part 2 of the Personal Care Manual addresses State Plan covered EPAS. For information related to traditional personal care services, see Part 1 of this manual.
Vision Care Services
WebVision care services are available for individuals eligible for Early Periodic Screening, Diagnosis, and Treatment (EPSDT) and pregnant women. Eyeglass services, including lenses and frames, are available to pregnant women and those eligible under the EPSDT program. Non-pregnant adults age 21 and older are NOT covered for eyeglass services.
Hospital Services
WebHospital Services. Hospital services are available to eligible Medicaid members with surgical, medical, diagnostic, or level of care needs that require the availability of specialized diagnostic and therapeutic services, and close medical supervision of care and treatment directed toward maintenance, improvement, or protection of health or
Physician Services Manual
WebPhysician services are a mandatory Medicaid, Title XIX program authorized by sections 1905 (a) and 1861 (r) of the Social Security Act, 42 CFR 440.50, and Sections 26-1-5 and 26-18-3, Utah Code Annotated. In addition to this provider manual, reference Utah Administrative Code Title R414. Health Care Financing, Coverage and Reimbursement …
Medical Transportation Services
WebDial-A-Ride is available for those members who cannot use the CATS fixed bus routes, and these members must fill out an application found on the CATS website. To schedule a ride with Dial-A-Ride, members should call: Weekdays, 7am-6pm (M-F): (435) 865-4510. Saturday, 10am-5:15pm: (435) 592-9117.
Pharmacy Services
Web340B Outpatient pharmacy (POS) All claims submitted to Utah Medicaid from a 340B covered entity for medications that were purchased through the 340B program must be submitted with the provider’s 340B actual acquisition cost in the Ingredient Cost Field, a value of “8” in the Basis of Cost field, and a value of “20” in the Submission Clarification …
Hospice Care Provider Manual
WebHospice Care Services. Hospice care services are covered for eligible Traditional Medicaid members when determined to be medically necessary as outlined in this manual. Hospice care services come from recognizing that a member's terminal condition warrants a change in focus from curative care to palliative care.
School-Based Skills Development Services
WebIntroduction. School-Based Skills Development services are Medicaid covered medically necessary diagnostic, preventative, and treatment services. These services include therapeutic interventions designed to ameliorate motor impairments, sensory loss, communication deficits, and/or psycho-social impairments.
Rehabilitative Mental Health and Substance Use Disorder Service
WebAuthority. Rehabilitative mental health and substance use disorder (SUD) services are provided under the authority of §1905 (a) (13) of the Social Security Act and 42 CFR §440.130, Diagnostic, Screening, Preventive, and Rehabilitative Services. In accordance with §1905 (a) (13) of the Social Security Act, outpatient rehabilitative mental
Autism Spectrum Services
WebGeneral Policy. Autism Spectrum Disorder (ASD) related services are non-covered benefits for Medicaid beneficiaries. ASD related services are only available under the Early Periodic Screening, Diagnosis, and Treatment program. The Early Periodic Screening, Diagnostic and Treatment (EPSDT) Program is a program that offers comprehensive and
Long Tern Care Program for Medicaid Clients Residing in a
WebThe deduction allowed from the gross entitlement amount varies according to the client’s marital status and the length of time the client is expected to stay in the facility. For married clients and long term stay (more than six months) clients, the following deductions apply: A personal needs allowance of $45.
Intellectual Disabilities
WebThe State of Utah has provided Medicaid-reimbursed home and community-based waiver services to individuals with intellectual disabilities and other related conditions since July 1, 1987. The Division of Integrated Healthcare (DIH) received approval from CMS through a waiver renewal process to continue operating the Community Supports Waiver for
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