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Hospital Services, 048-0037-26 Wyo. Code R. § 19

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Hospital Services
Establishes standards for Medicaid coverage of hospital services. Classifies hospitals services as covered services if they are provided by or at the direction of a licensed physician. Limits inpatient psychiatric services to stabilization of acute conditions and states that such services will be covered if a multidisciplinary team evaluates the patient within 48 hours of admission, prepares an individualized treatment plan, and documents treatment in the patient’s medical record. Limits coverage of outpatient hospital services, emergency department services —for non-emergencies—, and services at a physician’s office to 12 visits per year. Permits individuals to exceed this limit with prior authorization and specifics the circumstances when the limit does not apply (e.g., if the client is pregnant, seeking family planning services, under the age of 21, etc.).

Current as of January 2019