Refer to DMA’s website at http://www.dhhs.state.nc.us/dma/mp/mpindex.htm for specific coverage criteria, prior approval requirements, and service limitations.
The Medicaid program covers outpatient hospital services related to physician’s and dentist’s services that are needed for treating patients and for the physician’s and dentist’s professional component, outpatient diagnostic services, outpatient specialized therapies such as physical, speech, and occupational therapies. Covered outpatient therapeutic and rehabilitative services provided by the hospital include the use of hospital facilities, including clinic services and emergency room services.
Non-covered services include, but are not limited to:
REVISED 08/01/11 – CHANGE NO. 14-11
Outpatient hospital visits count toward the recipient professional services visits limit, EXCEPT as noted in II.A.
REISSUED 08/01/11 – CHANGE NO. 14-11
For questions or clarification on any of the policy contained in these manuals, please contact your local county office.