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; DHS 107.08 NoteNote: For more information on prior authorization, see s. DHS 107.02 (3). DHS 107.08(3)(a)(a) Inpatient limitations. The following limitations apply to hospital inpatient services: DHS 107.08(3)(a)1.1. Inpatient admission for non-therapeutic sterilization is a covered service only if the procedures specified in s. DHS 107.06 (3) are followed; and DHS 107.08(3)(a)2.2. A recipient’s attending physician shall determine if private room accommodations are medically necessary. Charges for private room accommodations shall be denied unless the private room is medically necessary and prescribed by the recipient’s attending physician. When a private room is not medically necessary, neither MA nor the recipient may be held responsible for the cost of the private room charge. If, however, a recipient requests a private room and the hospital informs the recipient at the time of admission of the cost differential, and if the recipient understands and agrees to pay the differential, then the recipient may be charged for the differential. DHS 107.08(3)(b)(b) Outpatient limitations. The following limitations apply to hospital outpatient services: DHS 107.08(3)(b)1.1. For services provided by a hospital on an outpatient basis, the same requirements shall apply to the hospital as apply to MA-certified non-hospital providers performing the same services; DHS 107.08(3)(b)2.2. Outpatient services performed outside the hospital facility may not be reimbursed as hospital outpatient services; and DHS 107.08(3)(b)3.3. All covered outpatient services provided during a calendar day shall be included as one outpatient visit. DHS 107.08(3)(c)2.2. If a hospital is certified and reimbursed as a type of provider other than a hospital, the hospital is subject to all coverage and reimbursement requirements for that type of provider. DHS 107.08(3)(c)3.3. On any given calendar day a patient in a hospital shall be considered either an inpatient or an outpatient, but not both. Emergency room services shall be considered outpatient services unless the patient is admitted as an inpatient and counted on the midnight census. Patients who are same day admission and discharge patients and who die before the midnight census shall be considered inpatients. DHS 107.08(3)(c)4.4. All covered services provided during an inpatient stay, except professional services which are separately billed, shall be considered hospital inpatient services.