DHS 107.03DHS 107.03 Services not covered. The following services are not covered services under MA: DHS 107.03(4)(4) Services provided by a particular provider that are considered experimental in nature; DHS 107.03(5)(5) Procedures considered by the department to be obsolete, inaccurate, unreliable, ineffectual, unnecessary, imprudent or superfluous; DHS 107.03(6)(6) Personal comfort items, such as radios, television sets and telephones, which do not contribute meaningfully to the treatment of an illness; DHS 107.03(7)(7) Alcoholic beverages, even if prescribed for remedial or therapeutic reasons; DHS 107.03(9)(9) Any service requiring prior authorization for which prior authorization is denied, or for which prior authorization was not obtained prior to the provision of the service except in emergency circumstances; DHS 107.03(10)(10) Services subject to review and approval pursuant to s. 150.21, Stats., but which have not yet received approval; DHS 107.03(11)(11) Psychiatric examinations and evaluations ordered by a court following a person’s conviction of a crime, pursuant to s. 972.15, Stats.; DHS 107.03(13)(13) Medical services for adult inmates of the correctional institutions listed in s. 302.01, Stats.; DHS 107.03(14)(14) Medical services for a child placed in a detention facility; DHS 107.03(15)(15) Expenditures for any service to an individual who is an inmate of a public institution or for any service to a person 21 to 64 years of age who is a resident of an institution for mental diseases (IMD), unless the person is 21 years of age, was a resident of the IMD immediately prior to turning 21 and has been continuously a resident since then, except that expenditures for a service to an individual on convalescent leave from an IMD may be reimbursed by MA. DHS 107.03(16)(16) Services provided to recipients when outside the United States, except Canada or Mexico; DHS 107.03(17)(17) Separate charges for the time involved in completing necessary forms, claims or reports; DHS 107.03(18)(18) Services provided by a hospital or professional services provided to a hospital inpatient are not covered services unless billed separately as hospital services under s. DHS 107.08 or 107.13 (1) or as professional services under the appropriate provider type. No recipient may be billed for these services as non-covered; DHS 107.03(19)(19) Services, drugs and items that are provided for the purpose of enhancing the prospects of fertility in males or females, including but not limited to the following: DHS 107.03(19)(a)(a) Artificial insemination, including but not limited to intra-cervical and intra-uterine insemination; DHS 107.03(19)(c)(c) Infertility testing, including but not limited to tubal patency, semen analysis or sperm evaluation; DHS 107.03(19)(d)(d) Reversal of female sterilization, including but not limited to tubouterine implantation, tubotubal anastomoses or fimbrioplasty; DHS 107.03(19)(e)(e) Fertility-enhancing drugs used for the treatment of infertility; DHS 107.03(19)(g)(g) Office visits, consultations and other encounters to enhance the prospects of fertility; and DHS 107.03(20)(20) Surrogate parenting and related services, including but not limited to artificial insemination and subsequent obstetrical care;