048-26 Wyo. Code R. §§ 26-4 - Covered Services

(a) The services and supplies specified in subsection (b) are covered services if medically necessary, subject to any exclusions or limitations contained in this Chapter and the Wyoming Department of Health.

(b) Covered services:

(i) Applied Behavior Analysis (ABA) Treatment, for individuals between the ages of 0-20 with a diagnosis of autism spectrum disorder;

(ii) Administrative Transportation;

(iii) Advanced Practitioner of Nursing (APN) services

(iv) Ambulance Services including Ground and Air;

(v) Ambulatory Surgical Center (ASC) Services;

(vi) Audiology Services and hearing aids;

(vii) Certified Registered Nurse Anesthetist (CRNA) services;

(viii) Certified Community Mental Health Center Services (CMHC);

(ix) Chiropractic Services

(x) Clubhouse Rehabilitation Services;

(xi) Certified Community Substance Abuse Treatment Center (SATC) Services

(xii) Comprehensive Outpatient Rehabilitation Facility (CORF) Services;

(xiii) Dental Services;

(xiv) Dietician Services;

(xv) Developmental Center Services;

(xvi) Durable Medical Equipment and Supplies;

(xvii) Emergency Hospital Services;

(xviii) Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services;

(xix) End Stage Renal Disease (ESRD) services;

(xx) Family Planning Clinic Services;

(xxi) Federally Qualified Health Center (FQHC) services;

(xxii) Home and Community Based Services (HCBS);

(xxiii) Home Health Services;

(xxiv) Hospice Services;

(xxv) Hospital Services (inpatient and outpatient);

(xxvi) Indian Health Service (IHS) and 638 Tribal Facilities;

(xxvii) Intermediate Care Facility for People with Intellectual Disabilities (ICF/ID) Services;

(xxviii) Institution for Mental Disease (IMD) Services furnished to individuals under twenty-two years of age and sixty-five years of age and older;

(xxix) Interpretation Services;

(xxx) Laboratory Services;

(xxxi) Mental Health Professional Services as defined in § 42-4-103 a (xx);

(xxxii) Midwife Services;

(xxxiii) Nurse Midwife (Certified) Services;

(xxxiv) Nursing Facility Services;

(xxxv) Nurse Practitioner Services

(xxxvi) Occupational Therapy Services;

(xxxvii) Pharmaceutical Services;

(xxxviii) Pharmacist Services;

(xxxix) Physical Therapy Services;

(xl) Physician Assistant Services;

(xli) Physician Services;

(xlii) Podiatry Services;

(xliii) Psychiatric Residential Treatment Facility (PRTF) Services;

(xliv) Psychology Services;

(xlv) Radiology Services;

(xlvi) Rural Health Clinic (RHC) Services;

(xlvii) School-Based Services as defined in Chapter 52;

(xlviii) Solid organ transplants and bone marrow transplants;

(A) For clients over the age of 21, transplants are limited to bone marrow, kidney, and liver;

(xlix) Speech Therapy Services;

(l) Swing bed Services;

(li) Targeted case management;

(lii) Vision Services and

(liii) Weight reduction treatment, including intestinal bypass surgery, gastric bypass surgery, and gastric stapling.

Notes

048-26 Wyo. Code R. §§ 26-4

Amended, Eff. 12/17/2015. Amended, Eff. 4/9/2019. Amended, Eff. 5/7/2020. Amended, Eff. 5/13/2021. Amended, Eff. 1/18/2025.