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4.3.2.2 Exceptions to Limited Status
The provider is not required to provide some services. Limited clients may go to any provider for the following services or items:
• Ambulance services.
•Anesthesia.
•Assistant surgery.
•Case management services.
•Chiropractic services.
•Counseling services provided by a chemical dependency treatment facility.
•Eye exams for refractive errors.
•Eyeglasses.
•Family planning services (regardless of place of service [POS]).
•Genetic services.
•Hearing aids.
•Home health services.
•Laboratory services (including interpretations).
•Licensed clinical social worker (LCSW) services.
•Licensed professional counselor (LPC) services.
•Mental health rehabilitation services.
•Mental retardation diagnostic assessment (MRDA) performed by an MRDA provider.
•Nursing facility services.
•Obstetrical/gynecological (OB/GYN) services.
Note: The once a year well-woman check up is covered without a referral. All other OB/GYN services require appropriate referrals.
•Primary home care.
•Psychiatric services.
•Radiology services (including interpretations).
•School Health and Related Services (SHARS).
•THSteps-CCP.
•THSteps medical and dental services.
For referrals or questions, contact:
HHSC
Office of Inspector General
Limited Program - MC 1323
PO Box 85200
Austin, TX 78708
1-800-436-6184
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