The following guidelines are found in the Nebraska Administrative Code
The Nebraska Medical Assistance Program (NMAP) uses the following definition of medical necessity:
Health care services and supplies which are medically appropriate and:
The fact that the physician has performed or prescribed a procedure or treatment or the fact that it may be the only treatment for a particular injury, sickness, or mental illness does not mean that it is covered by Medicaid. Services and supplies which do not meet the definition of medical necessity set out above are not covered.Approval by the federal Food and Drug Administration (FDA) or similar approval does not guarantee coverage by NMAP. Licensure/certification of a particular provider type does not guarantee NMAP coverage