(410 ILCS 225/6) (from Ch. 111 1/2, par. 7026)
Sec. 6. Covered services.
(a) Covered services under the program may include, but are not necessarily limited to, the following:
(1) Laboratory services related to a recipient's
pregnancy, performed or ordered by a physician, advanced practice nurse, or physician assistant.
(2) Screening and treatment for sexually transmitted
disease.
(3) Prenatal visits to a physician in the physician's
office, an advanced practice nurse in the advanced practice nurse's office, a physician assistant in the physician assistant's office, or to a hospital outpatient prenatal clinic, local health department maternity clinic, or community health center.
(4) Radiology services which are directly related to
the pregnancy, are determined to be medically necessary and are ordered by a physician, an advanced practice nurse, or a physician assistant.
(5) Pharmacy services related to the pregnancy.
(6) Other medical consultations related to the
pregnancy.
(7) Physician, advanced practice nurse, physician
assistant, or nurse services associated with delivery.
(8) One postnatal office visit within 60 days after
delivery.
(9) Two EPSDT-equivalent screenings for the infant
within 90 days after birth.
(10) Social and support services.
(11) Nutrition services.
(12) Case management services.
(b) The following services shall not be covered under the program:
(1) Services determined by the Department not to be
medically necessary.
(2) Services not directly related to the pregnancy,
except for the 2 covered EPSDT-equivalent screenings.
(3) Hospital inpatient services.
(4) Anesthesiologist and radiologist services during
a period of hospital inpatient care.
(5) Physician, advanced practice nurse, and physician
assistant hospital visits.
(6) Services considered investigational or
experimental.
(Source: P.A. 93-962, eff. 8-20-04.)
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