DHS 107.07(4)(L)(L) Professional visits, other than for the oral evaluation of a nursing home resident, or hospital calls as noted in sub. (1) (j) 4. DHS 107.07(4m)(4m) Non-covered services; dental hygienists. The following services are not covered by MA whether or not the service is performed by a person under the supervision of a dentist or physician or by a dental hygienist who is individually certified under ch. DHS 105: DHS 107.07(4m)(b)(b) Oral hygiene instruction or training in preventive dental care as a separate procedure, including tooth brushing technique, flossing or use of special oral hygiene aids, tobacco cessation counseling, or nutritional counseling. DHS 107.07(5)(5) Unusual circumstances. In certain unusual circumstances the department may request that a non-covered service be performed, including but not limited to diagnostic casts, in order to substantiate a prior authorization request. In these cases the service shall be reimbursed. DHS 107.07 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; am. (1) (c) 10. and (2) (c) 9. e. and f., cr. (2) (c) 9. g. and (3) (8), r. and recr. (4) (q), Register, February, 1988, No. 386, eff. 3-1-88; r. and recr. (1) (g) and (4) (j), renum. (2) (c) 9. to 12. and (4) (k) to (t) to be (2) (c) 10. to 13. and (4) (m) to (v), cr. (2) (c) 9., (4) (k) and (L), Register, December, 1989, No. 408, eff. 1-1-90; correction in (4) (j) made under s. 13.93 (2m) (b) 7., Stats., Register, December, 1989, No. 408; CR 05-033: r. and recr. (1), (3) and (4) cr. (1m), (2) (a) 5. to 7. and (4m), am. (2) (a) (intro.) and 1. to 4. and (2) (b), r. (2) (c) Register August 2006 No. 608, eff. 9-1-06; emerg. r. (1) (k) and (2) (a) 5., am. (2) (a) (intro.), (3) (intro.), (a) 3., (4) (intro.), (j) and (4m) eff. 4-30-07; CR 07-041: r. (1) (i), (k) and (2) (a) 5., am. (2) (a) (intro.), (3) (intro.), (a) 3., (4) (intro.), (j) and (4m) Register December 2007 No. 624, eff. 1-1-08; corrections in (1m) (intro.) and (4m) (intro.) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; CR 22-043: r. (4) (b), am. (4) (c), r. (4) (k) 1. Register May 2023 No. 809, eff. 6-1-23. DHS 107.08(1)(a)(a) Inpatient services. Covered hospital inpatient services are those medically necessary services which require an inpatient stay ordinarily furnished by a hospital for the care and treatment of inpatients, and which are provided under the direction of a physician or dentist in an institution certified under s. DHS 105.07 or 105.21. DHS 107.08(1)(b)(b) Outpatient services. Covered hospital outpatient services are those medically necessary preventive, diagnostic, rehabilitative or palliative items or services provided by a hospital certified under s. DHS 105.07 or 105.21 and performed by or under the direction of a physician or dentist for a recipient who is not a hospital inpatient. DHS 107.08(2)(2) Services requiring prior authorization. The following covered services require prior authorization: DHS 107.08(2)(a)(a) Covered hospital services if provided out-of-state under non-emergency circumstances by non-border status providers;