Medicaid Provider Manuals Archive

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
2023-CCW-1

Section 14.1 – Covered Services  

11/7/23 12/22/23 Section 14.1 – Covered Services  
2023-CCW-2

Section 14.2 – Beneficiary Requirements

11/7/23 12/22/23 Section 14.2 – Beneficiary Requirements
2023-CCW-3 Section 14.6 – Staffing Requirements 11/7/23 12/22/23 Section 14.6 – Staffing Requirements
2023-CCW-4 Section 14.8 – Reimbursement 11/7/23 12/22/23 Section 14.8 – Reimbursement
2023-CCW-5 Section 14.10 – Incidents, Accidents, and Complaints 11/7/23 12/22/23 Section 14.10 – Incidents, Accidents, and Complaints
2023-CCW-6

Section 14.11 – Support Coordination

11/7/23 12/22/23 Section 14.11 – Support Coordination
2023-CCW-7 Section 14.12 – Self-Direction Option 11/7/23 12/22/23 Section 14.12 – Self-Direction Option
2023-638 Clinics-1

Section 39.3 – Provider Requirements

11/2/23 12/17/23 Section 39.3 – Provider Requirements
2023-Home Health-8 Section 23.0 – Overview 10/25/23 12/9/23 Section 23.0 – Overview
2023-Home Health-9 Section 23.1 – Description of Services 10/25/23 12/9/23 Section 23.1 – Description of Services
2023-Home Health-10

Section 23.4 – Provider Requirements

10/25/23 12/9/23 Section 23.4 – Provider Requirements
2023-DME-3

Section 18.2.1.2 – Specific Coverage Criteria – Oxygen Concentrators

10/10/23 11/24/23 Section 18.2.1.2 – Specific Coverage Criteria – Oxygen Concentrators
2023-BHS-17

Section 2.3 – Outpatient Services – Crisis Response Services

9/26/23 11/10/23   Section 2.3 – Outpatient Services – Crisis Response Services 
2023-BHS-18

Appendix D – Approved Curriculum and Equivalency Standards

9/26/23  11/10/23   Appendix D – Approved Curriculum and Equivalency Standards
2023-BHS-19

Appendix F – CSoC Wraparound Model

9/26/23  11/10/23   Appendix F – CSoC Wraparound Model
2023-BHS-16

Appendix E-11 – Evidence Based Practices (EBPs) – Dialectical Behavioral Therapy (DBT)

9/15/23  10/30/23  Appendix E-11 – Evidence Based Practices (EBPs) – Dialectical Behavioral Therapy (DBT)
2023-General Information and Administration-1

Section 1.5 – Benefits for Children and Youth

9/11/23  10/26/23  Section 1.5 – Benefits for Children and Youth
2023-Professional Services-2

Section 5.1 – Covered Services – Anesthesia Services

8/30/23 10/14/23 Section 5.1 – Covered Services – Anesthesia Services
2023-PBMS-1

Section 37.1 – Covered Services, Exclusions, and Limitations

8/25/23 10/9/23 Section 37.1 – Covered Services, Exclusions, and Limitations
2023-DME-2

Section 18.2.20 – Specific Coverage Criteria - Diabetic Supplies and Equipment

8/22/23 10/6/23 Section 18.2.20 – Specific Coverage Criteria - Diabetic Supplies and Equipment
2023-F/EA-1

Section 3.0 - Overview

8/17/23 10/1/23 Section 3.0 - Overview
2023-F/EA-2 Section 3.1 – Covered Services   8/17/23 10/1/23 Section 3.1 – Covered Services  
2023-F/EA-3 Section 3.2 – Beneficiary Requirements 8/17/23 10/1/23 Section 3.2 – Beneficiary Requirements
2023-F/EA-4 Section 3.3 – Service Access and Authorization 8/17/23 10/1/23 Section 3.3 – Service Access and Authorization
2023-F/EA-5 Section 3.4 – Provider Requirements 8/17/23 10/1/23 Section 3.4 – Provider Requirements
2023-F/EA-6 Section 3.5 – Staffing and Training 8/17/23 10/1/23 Section 3.5 – Staffing and Training
2023-F/EA-7 Section 3.6 – Record Keeping 8/17/23 10/1/23 Section 3.6 – Record Keeping
2023-F/EA-8 Section 3.7 – Program Monitoring 8/17/23 10/1/23 Section 3.7 – Program Monitoring
2023-F/EA-9 Section 3.8 – Reimbursement 8/17/23 10/1/23 Section 3.8 – Reimbursement
2023-F/EA-10 Appendix B – Emergency Preparedness 8/17/23 10/1/23 Appendix B – Emergency Preparedness
2023-F/EA-11 Appendix C – Claims Filing 8/17/23 10/1/23 Appendix C – Claims Filing
2023-BHS-15 Appendix E-1 – Evidence Based Practices (EBPs) – Assertive Community Treatment (ACT) 8/16/23 9/30/23 Appendix E-1 – Evidence Based Practices (EBPs) – Assertive Community Treatment (ACT)
2023-Medical Transportation-1 Section 10.0 - Overview 8/7/23 9/21/23 Section 10.0 - Overview
2023-Medical Transportation-2 Section 10.2 – NEMT – Scheduling and Dispatching 8/7/23 9/21/23 Section 10.2 – NEMT – Scheduling and Dispatching
2023-Medical Transportation-3 Section 10.3 – NEMT - Provider Requirements 8/7/23 9/21/23 Section 10.3 – NEMT - Provider Requirements
2023-Medical Transportation-4 Section 10.4 – NEMT – Provider Responsibilities 8/7/23 9/21/23 Section 10.4 – NEMT – Provider Responsibilities
2023-Medical Transportation-5 Section 10.7 – Ambulance – Overview 8/7/23 9/21/23 Section 10.7 – Ambulance – Overview
2023-Medical Transportation-6 Section 10.8 – Ambulance - Emergency Ambulance Transportation 8/7/23 9/21/23 Section 10.8 – Ambulance - Emergency Ambulance Transportation
2023-Medical Transportation-7 Section 10.9 – Ambulance – Non-Emergency Ambulance Transportation 8/7/23 9/21/23 Section 10.9 – Ambulance – Non-Emergency Ambulance Transportation
2023-Medical Transportation-8 Section 10.10 – Ambulance – Air Ambulance 8/7/23 9/21/23 Section 10.10 – Ambulance – Air Ambulance
2023-Medical Transportation-9 Ambulance 10.13 – Ambulance – Claims and Encounters 8/7/23 9/21/23 Ambulance 10.13 – Ambulance – Claims and Encounters
2023-Professional Services-1 Section 5.1 – Covered Services – Tobacco Cessation Counseling Services 7/17/23 8/31/23 Section 5.1 – Covered Services – Tobacco Cessation Counseling Services
2023-BHS-14

Section 2.3 – Outpatient Services – Peer Support Services

7/17/23 8/31/23 Section 2.3 – Outpatient Services – Peer Support Services
2023-SW-3 Section 43.0 - Overview 7/6/23 8/20/23 Section 43.0 - Overview
2023-SW-4 Section 43.1 – Beneficiary Requirements 7/6/23 8/20/23 Section 43.1 – Beneficiary Requirements
2023-SW-5 Section 43.2 – Rights and Responsibilities 7/6/23 8/20/23 Section 43.2 – Rights and Responsibilities
2023-SW-6 Section 43.3 – Service Access Authorization 7/6/23 8/20/23 Section 43.3 – Service Access Authorization
2023-SW-7 Section 43.4 – Covered Services 7/6/23 8/20/23 Section 43.4 – Covered Services
2023-SW-8 Section 43.5 – Program Monitoring 7/6/23 8/20/23 Section 43.5 – Program Monitoring
2023-SW-9 Appendix A – Developmental Disability Law 7/6/23 8/20/23 Appendix A – Developmental Disability Law
2023-SW-10 Appendix B – Service Procedure Codes 7/6/23 8/20/23 Appendix B – Service Procedure Codes
2023-SW-11 Appendix C – Contact Referral Information 7/6/23 8/20/23 Appendix C – Contact Referral Information
2023-SW-12

Appendix D – Forms and Links

7/6/23 8/20/23 Appendix D – Forms and Links
2023-BHS-13

Section 2.6 – Record Keeping

 6/26/23  8/10/23 Section 2.6 – Record Keeping
2023-SW-1

Section 43.7 – Provider Requirements

6/22/23 8/6/23 Section 43.7 – Provider Requirements
2023-SW-2

Section 43.8 – Support Coordination

6/22/23 8/6/23 Section 43.8 – Support Coordination
2023-ABA-3

Section 4.4 - Provider Requirements

6/7/23 7/23/23 Section 4.4 - Provider Requirements
2023-BHS-12

Appendix E-11 – Evidence Based Practices – Dialectical Behavioral Therapy (DBT)

NOTE: This is a new section being incorporated, which will be available to the Medicaid population in the 2024 fiscal year.
6/6/23 7/22/23 Appendix E-11 – Evidence Based Practices – Dialectical Behavioral Therapy (DBT)
2023-BHS-11 Appendix E-2 – Evidence Based Practices – FFT-CW 6/1/23 7/16/23 Appendix E-2 – Evidence Based Practices – FFT-CW
2023-BHS-12 Appendix E-3 – Evidence Based Practices – Homebuilders 6/1/23 7/16/23 Appendix E-3 – Evidence Based Practices – Homebuilders
2023-BHS-9 Section 2.3 – Outpatient  Services – Outpatient Therapy by Licensed Practitioners 5/26/23 7/10/23 Section 2.3 – Outpatient  Services – Outpatient Therapy by Licensed Practitioners
2023-BHS-10 Section 2.3 – Outpatient Services - Crisis Response Services for Adults 5/26/23 7/10/23 Section 2.3 – Outpatient Services - Crisis Response Services for Adults
2023-Home Health-1 Section 23.0 – Overview 5/25/23 7/9/23 Section 23.0 – Overview
2023-Home Health-2 Section 23.1 – Description of Services 5/25/23 7/9/23 Section 23.1 – Description of Services
2023-Home Health-3 Section 23.2 – Service Limitations 5/25/23 7/9/23 Section 23.2 – Service Limitations 
2023-Home Health-4 Section 23.3 – Beneficiary Requirements 5/25/23 7/9/23 Section 23.3 – Beneficiary Requirements
2023-Home Health-5 Section 23.4 – Provider Requirements 5/25/23 7/9/23 Section 23.4 – Provider Requirements
2023-Home Health-6 Section 23.5 – Prior Authorization 5/25/23 7/9/23 Section 23.5 – Prior Authorization
2023-Home Health-7

Section 23.6 – Claims Related Information

5/25/23 7/9/23 Section 23.6 – Claims Related Information
2023-BHS-8

Section 2.3 – Outpatient Services – Mental Health Rehabilitation Services

*Revisions are contingent on CMS approval.
5/22/23 7/6/23 Section 2.3 – Outpatient Services – Mental Health Rehabilitation Services
2023-BHS-7 Appendix E-1 – Evidence Based Practices – Assertive Community Treatment 4/20/23 6/4/23 Appendix E-1 – Evidence Based Practices – Assertive Community Treatment
2023-ABA-1 Section 4.1 – Covered Services 4/6/23 5/21/23 Section 4.1 – Covered Services
2023-ABA-2 Section 4.5 - Reimbursement 4/6/23 5/21/23 Section 4.5 - Reimbursement
2023-HOSPITALS-1 Section 25.2 – Inpatient Services – Rapid Whole Genome Sequencing of Critically Ill Infants 3/31/23 5/15/23 Section 25.2 – Inpatient Services – Rapid Whole Genome Sequencing of Critically Ill Infants
2023-BHS-6 Section 2.3 – Outpatient  Services – Mental Health Rehabilitation Services 3/28/23 5/12/23 Section 2.3 – Outpatient  Services – Mental Health Rehabilitation Services
2023-BHS-5 Section 2.3 – Outpatient  Services – Outpatient Therapy by Licensed Practitioners 3/28/23 5/12/23 Section 2.3 – Outpatient  Services – Outpatient Therapy by Licensed Practitioners
2023-BHS-4 Section 2.4 – Addiction Services 3/28/23 5/12/23 Section 2.4 – Addiction Services
2023-PBMS-1 Section 37.1 – Covered Services, Exclusions, and Limitations 3/13/23 4/27/23 Section 37.1 – Covered Services, Exclusions, and Limitations
2023-NOW-1 Section 32.1 – Covered Services 2/23/23 4/9/23 Section 32.1 – Covered Services
2023-NOW-2 Section 32.2 – Self-Direction Option 2/23/23 4/9/23 Section 32.2 – Self-Direction Option
2023-NOW-3 Section 32.6 - Provider Requirements 2/23/23 4/9/23 Section 32.6 - Provider Requirements
2023-NOW-4 Section 32.7 - Staffing Requirements 2/23/23 4/9/23 Section 32.7 - Staffing Requirements
2023-NOW-5 Section 32.9 - Reimbursement 2/23/23 4/9/23 Section 32.9 - Reimbursement
2023-NOW-6 Section 32.12 - Support Coordination 2/23/23 4/9/23 Section 32.12 - Support Coordination
2023-NOW-7 Appendix E - Billing Codes 2/23/23 4/9/23 Appendix E - Billing Codes
2023-ROW-1 Section 38.0 - Overview 2/9/23 3/26/23 Section 38.0 - Overview
2023-ROW-2 Section 38.1 – Covered Services 2/9/23 3/26/23 Section 38.1 – Covered Services
2023-ROW-3 Section 38.2 – Self-Direction Option 2/9/23 3/26/23 Section 38.2 – Self-Direction Option
2023-ROW-4 Section 38.3 – Beneficiary Requirements 2/9/23 3/26/23 Section 38.3 – Beneficiary Requirements
2023-ROW-5 Section 38.4 – Rights and Responsibilities 2/9/23 3/26/23 Section 38.4 – Rights and Responsibilities
2023-ROW-6 Section 38.5 - Service Access and Authorization 2/9/23 3/26/23 Section 38.5 - Service Access and Authorization
2023-ROW-7 Section 38.6 - Provider Requirements 2/9/23 3/26/23 Section 38.6 - Provider Requirements
2023-ROW-8 Section 38.7 - Staffing Requirements 2/9/23 3/26/23 Section 38.7 - Staffing Requirements
2023-ROW-9 Section 38.8 - Record Keeping 2/9/23 3/26/23 Section 38.8 - Record Keeping
2023-ROW-10 Section 38.9 - Reimbursement 2/9/23 3/26/23 Section 38.9 - Reimbursement
2023-ROW-11 Section 38.10 - Program Monitoring 2/9/23 3/26/23 Section 38.10 - Program Monitoring
2023-ROW-12 Section 38.11 - Incidents, Accidents, and Complaints 2/9/23 3/26/23 Section 38.11 - Incidents, Accidents, and Complaints
2023-ROW-13 Section 38.12 - Support Coordination 2/9/23 3/26/23 Section 38.12 - Support Coordination
2023-ROW-14 Appendix E - Billing Codes 2/9/23 3/26/23 Appendix E - Billing Codes
2023-DME-1 Section 18.2.19 Ambulatory Equipment 2/3/23 3/20/23 Section 18.2.19 Ambulatory Equipment
2023-ABA-1 Section 4.1 – Covered Services 1/30/23 3/16/23 Section 4.1 – Covered Services
2023-BHS-1 Section 2.4 – Addiction Services – Opioid Treatment Programs (OTP)  1/18/23  3/4/23 Section 2.4 – Addiction Services – Opioid Treatment Programs (OTP)
2023-BHS-2 Section 2.4 – Addiction Services 1/18/23 3/4/23 Section 2.4 – Addiction Services
2023-BHS-3 Section 2.3 – Outpatient  Services – Mental Health Services 1/18/23 3/4/23 Section 2.3 – Outpatient  Services – Mental Health Services
RELATED INFO