1.1-A Attorney General’s Certification
1.1-B Waiver(s) of the Single State Agency Requirement Granted Under the Intergovernmental Cooperation Act
1.2-A Organization and Functions of the Medicaid Agency
1.2-B Organization and Function of the Medical Assistance Unit
1.2-C Medical Professionals Involved in the Administration of the Medical Assistance Program
2.2-A Groups Covered and Agencies Responsible for Eligibility Determinations
Supplement 1 Reasonable Classifications of Individuals under the Age of 21, 20, 19 and 18
Supplement 3 Method of Determining Cost Effectiveness of Caring for Certain Disabled Children at Home
2.6-A Eligibility Conditions and Requirements (States only)
Supplement 1 Income Eligibility Levels - Categorically Needy, Medically Needy and Qualified Medicare Beneficaries
Supplement 2 Resource Levels - Categorically Needy, Including Groups with Income Up to a Percentage of the Federal Proverty Level, Medically Needy, and Other Optional Groups
Supplement 3 Reasonable Limits on Amounts for Necessary Medical or Remedial Care Not Covered Under Medicaid
Supplement 4 Section 1902(f) Methodologies for Treatment of Income that Differ from Those of the SSI Program
Supplement 5 Section 1902(f) Methodologies for Treatment of Resources that Differ from Those of the SSI Program
Supplement 5a Methodologies for Treatment of Resources for Individuals With Incomes Up to a Percentage of the Federal Poverty Level
Supplement 6 Standards for Optional State Supplementary Payments
Supplement 7 Income Levels for 1902(f) States - Categorically Needy Who are Covered under Requirements More Restrictive Than SSI
Supplement 8 Resource Standards for 1902(f) States - Categorically Needy
Supplement 8a More Liberal Methods of Treating Income Under Section 1902(r)(2) of the Act
Supplement 8b More Liberal Methods of Treating Resources Under Section 1902(r)(2) of the Act
Supplement 9 Transfer of Resources
Supplement 9a Transfer of Assets
Supplement 10 Consideration of Medicaid Qualifying Trusts- Undue Hardship
Supplement 11 Cost - Effective Methods for COBRA Groups
Supplement 12 Eligibility Under Section 1931 of the Act
Supplement 13 Section 1924 Provisions
Supplement 14 Qualified Disabled and Working Individuals
Supplement 15 Variations From the Basic Personal Needs Allowance
Supplement 17 Disqualifications for Long-Term Care Assistance for Individuals with Substantial Home Equity
3.1-A Amount, Duration, and Scope of Medical and Remedial Care and Services Provided to the Categorically Needy
Item 1 Limitations - Inpatient Hospitals
Item 2a Limitations -Outpatient Hospitals
Item 2b Limitations -Rural Health Clinic Services
Item 2c Limitations -Federally Qualified Health Centers
Item 3 Limitations - Other Laboratory and X-Ray Services
Item 4a Limitations - Assessments of Developmentally Disabled Person in SNF
Item 4b Limitations - Early and Periodic Screening and Diagnosis and Treatment of Conditions Found
Item 5 Limitations - Physician’s Services
Item 6a Limitations - Podiatrists’ Services
Item 6b Limitations - Optometrists’ Services
Item 6c Limitations -Chiropractic Services
Item 6d Limitations - Other Practitioners Services
Item 7a Limitations - Home Health Nursing Services
Item 7b Limitations - Home Health Agencies – Home Health Aide Services
Item 7c Limitations - Medical Supplies, Equipment, and Appliances Suitable for Use in the Home
Item 7d Limitations - Home Health Services – Physical Therapy, Occupational Therapy, and Speech Pathology and Audiology
Item 8 Limitations - Private Duty Nursing Services
Item 9 Limitations - Clinic Services
Item 10 Limitations - Dental Services
Item 11a Limitations - Physical Therapy
Item 11b Limitations - Occupational Therapy
Item 11c Limitations - Services for Individuals with Speech, Hearing, and Language Disorders
Item 12a Limitations - Prescribed Drugs
Item 12b Limitations - Dentures
Item 12c Limitations - Prosthetic Devices
Item 12d Limitations - Eye Glasses
Item 13b Limitations - Screening Services
Item 13d Limitations - Rehabilitative Services
Item 14a Limitations - Services for Individuals Age 65 or Older in Institutions for Mental Diseases – Inpatient Hospital Services
Item 14b Limitations - Services for Individuals Age 65 or Older in Institutions for Mental Diseases – Skilled Nursing Facility Services
Item 14c Limitations - Services for Individuals Age 65 or Older in Institutions for Mental Diseases – Intermediate Care Facility Services
Item 15 Limitations - ICF-MR Services
Item 16 Limitations - Inpatient Psychiatric Facility Services for Individuals Under Age 21
Item 17 Limitations - Nurse-Midwife Services
Item 18 Limitations - Medical and Remedial Care and Services
Item 20a Limitations - Pregnancy-related and Postpartum Services for 60 Days After the Pregnancy Ends
Item 20b Limitations - Services for Any Other Medical Conditions that May Complicate Pregnancy
Item 23 Limitations - Certified Pediatric or Family Nurse Practitioners’ Services
Item 24a Limitations - Transportation
Item 24d Limitations - Nursing Facility Services for Patients Under 21 Years of Age
Item 24e Limitations - Emergency Hospital Services
Item 24f Limitations – Critical Access Hospitals
Item 26 Limitations - Personal Assistance Services
Item 27 Limitations - Freestanding Birth Center Services
Supplements 1-3 Case Management Services
Supplement 4 PACE
3.1-B Amount, Duration, and Scope of Services Provided Medically Needy Groups
3.1-C Standards and Methods of Assuring High Quality Care
3.1-D Transportation
3.1-E Standards for the Coverage of Organ Transplant Services
3.1-F MCO and enhanced PCCM programs
3.2-A Coordination of Title XIX with Part B of Title XVIII
4.11-A Standards for Institutions
4.16-A Cooperative Arrangements with State Health and State Vocational Rehabilitation Agencies and with Title V Grantees
4.17-A Determining that an Institutionalized Individual Cannot Be Discharged and Returned Home – Liens and Adjustments or Recoveries
4.18-A Charges Imposed on Categorically Needy
4.18-B Medically Needy - Premium
4.18-C Charges Imposed on Medically Needy and Other Optional Groups
4.18-D Premiums Imposed on Low Income Pregnant Women and Infants
4.18-E Premiums Imposed on Qualified Disabled and Working Individuals
4.18-F Premiums for Families Above 100% of FPL
4.19-A Methods and Standards for Establishing Payment Rates - Inpatient Hospital Care
4.19-B Methods and Standards for Establishing Payment Rates - Other Types of Care
Item 1 General statement on fee schedules
Item 1a General statement on telehealth fees
Item 1c Payment Adjustment for Provider Preventable Conditions
Item 2a Outpatient hospital and emergency room; hospital-affiliated ambulatory surgical centers, out-of-state hospital; telehealth
Item 2b Rural Health Centers/Clinic; telehealth;
Item 2c Federally-qualified health centers; telehealth
Item 2d Indian Health Service and Tribal health facilities; telehealth
Item 3 Other laboratory and x-ray services; telehealth;
Item 4a Skilled nursing facilities
Item 4b EPSDT; telehealth
Item 4c Family Planning Services; telehealth
Item 5 Physicians’ services; telehealth
Item 6a Podiatrists’ services; telehealth
Item 6b Optometrists’ services; telehealth
Item 6c Chiropractors’ services; telehealth
Item 6d Other practitioner services - Certified registered nurse anesthetists; telehealth
Item 7 Home Health Services; telehealth
Item 7c Medical supplies, equipment, and appliances for suitable use in the home
Item 8 Private duty nursing services
Item 9 Clinic services and outpatient mental health services; telehealth; ambulatory surgical centers
Item 10 Dental Services; telehealth
Item 11a Physical Therapy; telehealth
Item 11b Occupational Therapy; telehealth
Item 11c Speech, hearing, and Language services
Item 12a Prescribed drugs
Item 12b Dentures
Item 12c Prosthetic devices
Item 12d Eyeglasses
Item 13b Screening services; telehealth
Item 13d Community-based comprehensive psychiatric rehabilitation and support services program; telehealth; Assertive Community Treatment
Item 14a Services for Individuals Age 65 or Older in Institutions for Tuberculosis
Item 14b Individuals age 65 or older in institutions for mental diseases
Item 15 Intermediate Care Facility Services
Item 16 Inpatient psychiatric facilities for individuals age 21 or younger; telehealth
Item 17 Nurse midwife services
Item 18 Medical and remedial care and services
Item 19 Case Management services
Item 20 Extended services to pregnant women; telehealth
Item 21 Ambulatory prenatal care for pregnant women furnished during a presumptive eligibility period; telehealth
Item 23 Pediatric or family nurse practitioners
Item 23a Ambulance and Other Medical Transportation
Item 24a Transportation
Item 24d Skilled nursing facility services for patients under 21 years of age
Item 24e Emergency hospital services
Item 26 Personal Care Aid services
Item 27 Freestanding Birth Center Services
Supplement 1 Methods and Standards for Establishing Payment Rates for Title XVIII Deductible/Coinsurance
4.19-C Payments for Reserved Beds
4.19-D Methods and Standards for Establishing Payment Rates - Skilled Nursing and Intermediate Care Facility Services
4.19-E Timely-Claims Payment - Definition of Claim
4.22-A Requirements for Third Party Liability - Identifying Liable Resources
4.22-B Requirements for Third Party Liability - Payment of Claims
4.22-C State Methodology on Cost-Effectiveness of Employer-Based Group Health Plans