Table 2.7 Medical Necessity Standards

CA

CO

CT

FL

IA

KS

MI

MS

MT

NH

NY

PA

TX

UT

VA

General coverage rule

X

X

X

X

X

X

X

Medical necessity standard

X

X

X

X

X

X

X

Pediatric medical necessity standard

X

X

X

X

X

X

Mental health or substance abuse related medical necessity standard

X

X

X

Pregnancy medical necessity standard

TB medical necessity standard

Dual diagnosis medical necessity definition