Medicaid Provider Manuals Archive (2022)

The intent of the provider services manual is to present useful information and guidance to providers participating in the Louisiana Medicaid Program. The first chapter, "General Information and Administration" contains information applicable to all providers. Each remaining chapter is dedicated to a specific program or service and outlines the policies, procedures, qualifications, services and limitations to that service or program. Click here to view current provider manuals.

Below are items previously posted for public comment:

Item Number Provider Manual Chapter Date Posted Comment Period Closed Document Links
2022-Home Health Services-1 Section 23.5 – Prior Authorization 11/30/22 1/14/23 Section 23.5 – Prior Authorization
2022-Home Health Services-2 Section 23.2 – Service Limitations 11/30/22 1/14/23 Section 23.2 – Service Limitations
2022-BHS-9 Section 2.4 – Addiction Services 11/10/22 12/25/22 Section 2.4 – Addiction Services
2022-DME-5 Section 18.2 – Specific Coverage Criteria –Human Donor Milk 10/31/22 12/15/22 Section 18.2 – Specific Coverage Criteria –Human Donor Milk
2022-ICF-IID-1 Section 26.11 –  Rate Determination 10/13/22 11/27/22 Section 26.11 –  Rate Determination
2022-BHS-7 Appendix D - Approved Curriculum and Equivalency Standards 10/7/22 11/21/22 Appendix D - Approved Curriculum and Equivalency Standards
2022-BHS-8 Appendix G-2 – Employment Supports for Members Receiving Community Psychiatric Support and Treatment (CPST) and Psychological Rehabilitation (PSR) 10/7/22 11/21/22 Appendix G-2 – Employment Supports for Members Receiving Community Psychiatric Support and Treatment (CPST) and Psychological Rehabilitation (PSR)
2022-BHS-5 Section 2.2 - Bed Based Services – Crisis Stabilization for Youth 9/28/22 11/12/22 Section 2.2 - Bed Based Services – Crisis Stabilization for Youth
2022-BHS-6

Section 2.3 – Outpatient Services – Rehabilitation Services

*Revisions to include Act 503 implementation contingent on CMS approval.
9/28/22 11/12/22

Section 2.3 – Outpatient Services – Rehabilitation Services

2022-PDHC-1 Section 45.3 – Provider Requirements 9/26/22 11/10/22 Section 45.3 – Provider Requirements
2022-PDHC-2 Section 45.4 – Staffing Requirements 9/26/22 11/10/22 Section 45.4 – Staffing Requirements
2022-Vision-1 Section 46.1 – Covered Services 9/16/22 10/31/22 Section 46.1 – Covered Services
2022-EPSDT-PCS-1 Section 30.14 – EPSDT-PCS Covered Services 9/15/22 10/30/22 Section 30.14 – EPSDT-PCS Covered Services
2022-EPSDT-PCS-2 Section 30.15  – EPSDT-PCS Recipient Requirements 9/15/22 10/30/22 Section 30.15  – EPSDT-PCS Recipient Requirements
2022-EPSDT-PCS-3 Section 30.18 – EPSDT-PCS Provider Requirements 9/15/22 10/30/22 Section 30.18 – EPSDT-PCS Provider Requirements
2022-EPSDT-PCS-4 Section 30.20 – EPSDT-PCS Record Keeping 9/15/22 10/30/22 Section 30.20 – EPSDT-PCS Record Keeping
2022-EPSDT-PCS-5 Section 30.21 – EPSDT-PCS Reimbursement 9/15/22 10/30/22 Section 30.21 – EPSDT-PCS Reimbursement
2022-Professional Services-7 Section 5.1 – Covered Services – Gynecology 8/22/22 10/6/22 Section 5.1 – Covered Services – Gynecology
2022-Professional Services-6 Section 5.1 – Covered Services – Anesthesia 8/22/22 10/6/22 Section 5.1 – Covered Services –Anesthesia
2022-ICF-IID-1 Section 26.12 – Cost Reports 8/22/22 10/6/22 Section 26.12 – Cost Reports
2022-BHS-4 Section 2.3 – Outpatient Services – Peer Support Services 8/19/22 10/3/22 Section 2.3 – Outpatient Services – Peer Support Services
2022-BHS-3 Section 2.5 – Coordinated System of Care (CSoC) 8/19/22 10/3/22 Section 2.5 – Coordinated System of Care (CSoC)
2022-DME-4 Section 18.2 – Specific Coverage Criteria –Portable Oxygen 8/26/22 9/30/22 Section 18.2 – Specific Coverage Criteria –Portable Oxygen
2022-Professional Services-5 Section 5.1 – Covered Services - Routine Care Provided to Beneficiaries Enrolled in Clinical Trials 8/4/22 9/18/22 Section 5.1 – Covered Services - Routine Care Provided to Beneficiaries Enrolled in Clinical Trials
2022-Medical Transportation-4 Section 10.3 – Provider Requirements 8/2/22 9/8/22 Section 10.3 – Provider Requirements
2022-DME-3 Section 18.2 – Specific Coverage Criteria 7/19/22 9/2/22 Section 18.2 – Specific Coverage Criteria
2022-BHS-3 Section 2.3 – Outpatient Services – Individual Placement and Support (IPS) 7/1/22 8/15/22 Section 2.3 – Outpatient Services – Individual Placement and Support (IPS)
2022-Professional Services-4 Section 5.1 – Covered Services – Immunizations 5/24/22 7/8/22 Section 5.1 – Covered Services – Immunizations
2022-Medical Transportation-1 Section 10.1 – Covered Services 5/17/22 7/1/22 Section 10.1 – Covered Services
2022-Medical Transportation-2 Section 10.3 – Provider Requirements 5/17/22 7/1/22 Section 10.3 – Provider Requirements
2022-Medical Transportation-3 Section 10.8 – Emergency Ambulance Transportation 5/17/22 7/1/22 Section 10.8 – Emergency Ambulance Transportation
2022-BHS-2 Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners 5/17/22 7/1/22 Section 2.3 – Outpatient Services – Outpatient Therapy by Licensed Practitioners
2022-NOW-1 Section 32.1 – Covered Services 5/13/22 6/27/22 Section 32.1 – Covered Services
2022-SW-1 Section 43.4 – Covered Services 5/13/22 6/27/22 Section 43.4 – Covered Services
2022-ROW-1 Section 38.1 – Covered Services 5/13/22 6/27/22 Section 38.1 – Covered Services
2022–Hospice-1 Section 24.3 – Covered Services 5/12/22 6/26/22 Section 24.3 – Covered Services
2022–Hospice-2 Section 24.5 – Provider Requirements 5/12/22 6/26/22 Section 24.5 – Provider Requirements
2022–Hospice-3

Section 24.10 – Claims Related Information

5/12/22 6/26/22 Section 24.10 – Claims Related Information
2022-Professional Services-3

Section 5.1 – Covered Services – Telemedicine/Telehealth

5/12/22 6/26/22 Section 5.1 – Covered Services – Telemedicine/Telehealth
2022-PBMS-1

Section 37.1 – Covered Services, Exclusions, and Limitations

5/10/22 6/24/22 Section 37.1 – Covered Services, Exclusions, and Limitations
2022-BHS-1

Section 2.3 – Outpatient Services – Crisis Response Services for Adults

5/10/22 6/24/22 Section 2.3 – Outpatient Services – Crisis Response Services for Adults
2022–Professional Services-2

Section 5.1 – Allergy Testing and Immunotherapy  

4/20/22 6/4/22 Section 5.1 – Allergy Testing and Immunotherapy
2022-DME-2 Section 18.2 – Specific Coverage Criteria 4/8/22 5/23/22 Section 18.2 – Specific Coverage Criteria
2022-Hospitals-1 Section 25.3 – Outpatient Services  3/21/22 5/5/22  Section 25.3 – Outpatient Services
2022-Professional Services-1 Section 5.1 – Laboratory and Radiology Services 3/21/22 5/5/22 Section 5.1 – Laboratory and Radiology Services
2022-DME-1 Section 18.2 – Specific Coverage Criteria 1/14/22 2/28/22 Section 18.2 – Specific Coverage Criteria
2022-BH-1 Section 2.3 – Outpatient Services - IPS 1/6/22 2/20/22 Section 2.3 – Outpatient Services - IPS
2022-BH-2

Section 2.3 – Outpatient Services - PCS

1/6/22 2/20/22 Section 2.3 – Outpatient Services - PCS

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