Physical Health Benefits

AVAILABLE PHYSICAL HEALTH CARE SERVICES SERVICES TITLE XIX TITLE XXI

The table below lists physical health care services available for Title XIX/XXI eligible persons determined to have a Serious Mental Illness (SMI), who are receiving both behavioral health and physical health care services from their Integrated RBHA (see the AHCCCS Covered Services, Acute Care, listed in the AHCCCS Medical Policy Manual, for further information on covered physical health care services and dental services).

 

PHYSICAL HEALTH CARE SERVICES

Title XIX under the age of 21

Title XIX 21 years of age and older

Title XXI under the age of 19

Audiology

X

X

X

Breast Reconstruction after Mastectomy

X

X

X

Chiropractic Services

X

 

X

Cochlear Implants

X

 

X

Emergency Dental Services

X

 

X

Preventative & Therapeutic Dental Services

X

 

X

Limited Medical and Surgical Services by a Dentist (for Members Age 21 and older)  

X

X

Supplemental Dental Coverage Based on Criteria Established by Cenpatico

X

X

X

Dialysis

X

X

X

Emergency Services – Medical

X

X

X

Emergency Eye Exam

X

X

X

Vision Exam/Prescriptive Lenses

X

 

X

Lens Post Cataract Surgery

X

X

X

Treatment for Medical Condition of the Eye

X

X

X

Health Risk Assessment & Screening Tests (for Members age 21 and older)  

X

 

Preventive Examinations in the Absence of any Known Disease or Symptom

X

 

X

HIV/AIDS Antiretroviral Therapy

X

X

X

Home Health Services

X

X

X

Hospice

X

X

X

Hospital Inpatient Medical

X

X

X

Hospital Observation

X

X

X

Hospital Outpatient Medical

X

X

X

Hysterectomy (medically necessary)

X

X

X

Immunizations

X

X

X

Laboratory

X

X

X

Maternity Services

X

X

X

Family Planning

X

X

X

Early and Periodic Screening, Diagnosis and Treatment (Medical Services)

X

 

X

Other Early and Periodic Screening, Diagnosis and Treatment Services Covered by Title XIX/XXI

X

 

X

Medical Foods

X

X

X

Durable Medical Equipment

X

X

X

Medical Supplies

X

X

X

Prosthetic

X

X

X

Orthotic Devices

X

 

X

Nursing Facilities (up to 90 days)

X

X

X

Non-Physician First Surgical Assistant

X

X

X

Physician Services

X

X

X

Foot and Ankle Services

X

X

X

Prescription Drugs

X

X

X

Primary Care Provider Services

X

X

X

Private Duty Nursing

X

X

X

Radiology and Medical Imaging

X

X

X

Occupational Therapy – Inpatient

X

X

X

Occupational Therapy – Outpatient

X

 

X

Physical Therapy – Inpatient

X

X

X

Physical Therapy – Outpatient

X

X

X

Speech Therapy – Inpatient

X

X

X

Speech Therapy – Outpatient

X

 

X

Respiratory Therapy

X

X

X

Total Outpatient Parenteral Nutrition

X

X

X

Non-Experimental Transplants Approved for Title XIX/XXI Reimbursement*    

 

Transplant Related Immunosuppressant Drugs

X

X

X

Transportation – Emergency

X

X

X

Transportation – Non-emergency

X

X

X

Triage

X

X

X

Well Exams  

X