Medically necessary service definition

Medically necessary service means a medical, surgical, or other services required for the prevention, diagnosis, cure, or treatment of a health- related condition including any such services that are necessary to slow or prevent a decremental change in medical and/or mental health status.

Medically necessary service means that:

Medically necessary service means a covered service that, in a manner consistent with accepted standards of medical practice, is reasonably expected to:

Examples of Medically necessary service in a sentence

• Topic #3869 ModifiersThe following are allowable modifiers for enteral nutrition products that should be indicated on PA (prior authorization) requests and claims: ● BO — Orally administered nutrition, not by feeding tube.● SC — Medically necessary service or supply.

• Medically necessary service requirements apply to all medical assistance program rules.

• Medically necessary service or supply means one which is ordered by a physician and which the small employer carrier or a qualified party or entity selected by us determines is: (1-25-95) a.

• Topic #3869 ModifiersThe following are allowable modifiers for enteral nutrition products that should be indicated on PA (prior authorization) requests and claims: ● BO — Orally administered nutrition, not by feeding tube● SC — Medically necessary service or supply Providers are required to indicate modifier BO on PA requests and claims for enteral nutrition products taken orally.

• IS AMENDED TO READ AS FOLLOWS: 405 IAC 5-2-17 "Medically necessary service" definedAuthority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2 Affected: IC 12-13-7-3; IC 12-15 Sec.

More Definitions of Medically necessary service

Medically necessary service means a covered dental service, requested by specialty care referral, which is: (1) adequate, appropriate and essential for the evaluation, diagnosis and treatment of a dental condition or disease; and (2) consistent with nationally accepted standards of practice.

Medically necessary service means a service or treatment that is absolutely necessary to treat or diagnose a patient and could adversely affect the patient’s condition, illness or injury if it were omitted, and the service or treatment is not considered an elective or cosmetic surgery service or treatment.

Medically necessary service means any inpatient or outpatient service, including pharmaceuticals or supplies provided by the hospital to a patient covered under Title XVII of the Federal Social Security Act for beneficiaries with the same clinical presentation as the uninsured patient. A Medically Necessary service does not include: (1) non-medical services such as social or vocational services; (2) Elective self-pay packages as defined by Self-Pay Package policies, or(3) elective cosmetic surgery (exclusive of plastic surgery designed to correct disfigurement cause by injury, illness or congenital defect or deformity).

Medically necessary service is a Service that is: (i) appropriate for the care, diagnosis or treatment of an Eligible Person; (ii) provided in the least costly medically appropriate setting based on the severity of illness and intensity of service required; (iii) not solely for the Eligible Person’s convenience or that of a health care professional; and (iv) within standards of practice within the community.

Medically necessary service. , as used in this document, means a covered service that, in a manner consistent with accepted standards of medical practice, is reasonably expected to:

Medically necessary service means a service or item reimbursable under the Montana Medicaid program, as provided in these rules:

Medically necessary service means that: older;