Acute Care Services

• Clinic Services, by an organized facility or clinic not part of a hospital: Freestanding Ambulatory Surgery Center
• Clinic Services, by an organized facility or clinic not part of a hospital: Public Health and Mental Health Clinics
• Federally Qualified Health Center Services
• Inpatient Hospital Services, other than in an Institution for Mental Diseases
• Outpatient Hospital Services
• Rehabilitation Services: Mental Health and Substance Abuse
• Rural Health Clinic Services

• Certified Registered Nurse Anesthetist Services
• Chiropractor Services
• Dental Services
• Medical and Remedial Care - Other Practitioners
• Medical/Surgical Services of a Dentist
• Nurse Midwife Services
• Nurse Practitioner Services
• Optometrist Services
• Physician Services
• Podiatrist Services
• Psychologist Services

• Prescription Drugs

• Occupational Therapy Services
• Physical Therapy Services
• Services for Speech, Hearing and Language Disorders

• Dentures
• Eyeglasses
• Hearing Aids
• Medical Equipment and Supplies
• Prosthetic and Orthotic Devices

• Ambulance Services
• Non-Emergency Medical Transportation Services

• Diagnostic, Screening and Preventive Services
• Early and Periodic Screening, Diagnosis and Treatment
• Extended Services for Pregnant Women
• Family Planning Services
• Laboratory and X-Ray Services, outside Hospital or Clinic
• Targeted Case Management

Long-Term Care Services

• Home Health Services
• Hospice Care
• Personal Care Services
• Private Duty Nursing Services
• Home and Community Based Services Waiver
• Program of All-Inclusive Care for the Elderly

• Inpatient Psychiatric Services, under age 21
• Inpatient Hospital, Nursing Facility and Intermediate Care Facility Services In Institutions for Mental Diseases, age 65 and older
• Intermediate Care Facility Services for the Mentally Retarded
• Nursing Facility Services, other than in an Institution for Mental Diseases
• Religious Non-Medical Health Care Institution and Practitioner Services