Table 2.7 Medical Necessity Standards
| AL | AR | CA | FL | GA | ID | IN | IA | KS | KY | LA | MA | MS | |
| General coverage rule | X | X | |||||||||||
| Medical necessity standard | X | ||||||||||||
| Pediatric medical necessity standard | |||||||||||||
| Mental health or substance abuse related medical necessity standard | |||||||||||||
| Pregnancy medical necessity standard | |||||||||||||
| TB medical necessity standard | |||||||||||||
| Dual diagnosis medical necessity definition |
Table 2.7 Medical Necessity Standards part 2
| MT | NE | NY | NC | ND | OK | PA | SD | TX | VT | VA | WA | WV | |
| General coverage rule | X | X | X | ||||||||||
| Medical necessity standard | X | X | |||||||||||
| Pediatric medical necessity standard | X | ||||||||||||
| Mental health or substance abuse related medical necessity standard | |||||||||||||
| Pregnancy medical necessity standard | |||||||||||||
| TB medical necessity standard | |||||||||||||
| Dual diagnosis medical necessity definition |
![]()