DHS 107.06(5)(v)(v) Vector cardiogram;
DHS 107.06(5)(w)(w) Non-emergency gastric bypass or gastric stapling for obesity; and
DHS 107.06(5)(x)(x) Separate charges for pump technician services.
DHS 107.06 NoteNote: For more information on non-covered services, see s. DHS 107.03.
DHS 107.06 HistoryHistory: Cr. Register, February, 1986, No. 362, eff. 3-1-86; cr. (2) (cm), (4) (h) and (5) (y), am. (4) (a) 3. Register, February, 1988, No. 386, eff. 3-1-88; am. (4) (a) 1. c., p. and q., cr. (4) (a) 1. r., Register, April, 1988, No. 388, eff. 7-1-88; r. (2) (cm) and (5) (y), r. and recr. (4) (h), Register, December, 1988, No. 396, eff. 1-1-89; r. (2) (zh), (zk), (zo), (zp) and (4) (a), renum. (2) (zi) to (zw) to be (zh) to (zs) and am. renum. (4) (b) to (h) to be (4) (a) to (g), cr. (2) (zt), r. (4) (a), Register, September, 1991, No. 429, eff. 10-1-91; r. and recr. (2) (h) and (5) (a), r. (2) (zb), (zc), zl), (zn), (zp), (zq) and (zs), renum. (2) (zd), (ze) to (zk), (zm), (zo), (zr) and (zt) to be(zb), (zc) to (zi), (zj), (zk), (zL) and (zm) and am.(2) (zc) and (zm), am. (5) (w) and (x), cr. (2) (zn) and (zo), (4) (h) and (i), Register, January, 1997, No. 493, eff. 2-1-97; correction in (4) (a) made under s. 13.93 (2m) (b) 7., Stats., Register, April, 1999, No. 520; correction in (3) (b) 3. (intro.) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636; republication of (3) (e) 5. to reinsert text inadvertently dropped in 1991, Register February 2019 No. 758; CR 20-039: r. (4) (e) Register October 2021 No. 790, eff. 11-1-21; CR 20-068: am. (3) (d) (intro), 1. a. to f., 2. to 6., 7. (intro.), a., b. Register December 2021 No. 792, eff. 1-1-22; CR 22-043: am. (1), cr. (4) (cm), r. (5) (c) Register May 2023 No. 809, eff. 6-1-23; CR 23-046: r. (3) (b) 1. Register April 2024 No. 820, eff. 5-1-24.
DHS 107.065DHS 107.065Anesthesiology services.
DHS 107.065(1)(1)Covered services. Anesthesiology services covered by the MA program are any medically necessary medical services applied to a recipient to induce the loss of sensation of pain associated with surgery, dental procedures or radiological services. These services are performed by an anesthesiologist certified under s. DHS 105.05, or by a nurse anesthetist or an anesthesiology assistant certified under s. DHS 105.055. Anesthesiology services shall include preoperative, intraoperative and postoperative evaluation and management of recipients as appropriate.
DHS 107.065(2)(2)Other limitations.
DHS 107.065(2)(a)(a) A nurse anesthetist shall perform services in the presence of a supervising anesthesiologist or performing physician.
DHS 107.065(2)(b)(b) An anesthesiology assistant shall perform services only in the presence of a supervising anesthesiologist.
DHS 107.065 HistoryHistory: Cr. Register, September, 1991, No. 429, eff. 10-1-91; correction in (1) made under s. 13.92 (4) (b) 7., Stats., Register December 2008 No. 636.
DHS 107.07DHS 107.07Dental services.
DHS 107.07(1)(1)Covered services; dentists and physicians. Except as provided under subs. (2), (3), (4) and (4m), all of the following dental services are covered services when provided by or under the supervision of a dentist or physician within the scope of practice of dentistry as defined in s. 447.01 (8), Stats.:
DHS 107.07(1)(a)(a) Diagnostic services.
DHS 107.07(1)(b)(b) Preventive services.
DHS 107.07(1)(c)(c) Restorative services.
DHS 107.07(1)(d)(d) Endodontic services.
DHS 107.07(1)(e)(e) Periodontic services.
DHS 107.07(1)(f)(f) Removable prosthodontic services.
DHS 107.07(1)(g)(g) Fixed prosthodontic services.
DHS 107.07(1)(h)(h) Oral and maxillofacial surgery services.
DHS 107.07(1)(j)(j) All of the following other services:
DHS 107.07(1)(j)1.1. Unclassified treatment.
DHS 107.07(1)(j)2.2. Palliative emergency treatment.
DHS 107.07(1)(j)3.3. General anesthesia, intravenous conscious sedation, nitrous oxide, and non-intravenous conscious sedation.
DHS 107.07(1)(j)4.4. Hospital calls.
DHS 107.07 NoteNote: Orthodontia may be covered under early and periodic screening, diagnosis and treatment (EPSDT) services. Please see s. DHS 107.22 (4).
DHS 107.07(1m)(1m)Covered services; dental hygienists. Except as provided under subs. (2), (3), (4), and (4m), all of the following dental services are covered services when provided by a dental hygienist who is individually certified under ch. DHS 105 within the scope of dental hygiene as defined in s. 447.01 (3), Stats.:
DHS 107.07(1m)(a)(a) Oral screening and preliminary examination.