Under the Medicaid Program, the following services require prior authorization by the OHCA for all recipients under 21 years of age:
- (1) Orthotic procedures (HCPCS Codes L5000 to L9999)
- (2) Appliances (orthopedic, hearing aids)
- (3) Dental services requiring a treatment plan as indicated in Subchapter 5 (Part 79 of this Chapter)
- (4) Food supplements
- (5) Hyperalimentation
- (6) Enteral therapy
- (7) Emergency medical services for certain aliens.
- (8) Adaptive Equipment for persons residing in private ICF/MR's.
- (9) Outpatient psychotherapy by a psychologist for children under three.
- (10) Psychological testing by a psychologist beyond four hours per recipient each 12 months.
- (11) Diagnosis and treatment services not otherwise covered under the program when identified during an EPSDT screening examination.