<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s56821ea7-35d3-4f65-b31b-90b929adb586P0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s56821ea7-35d3-4f65-b31b-90b929adb586C0 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s56821ea7-35d3-4f65-b31b-90b929adb586C0-000000 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001 { color: black; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s56821ea7-35d3-4f65-b31b-90b929adb586000002 { color: black; background: white; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003 { color: #0000FF; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:39:10"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000000">67:16:39:10</span></a><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001">.  Primary care </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001">provider program</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001"> services.</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> Primary care </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">provider program</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> services include the following medically necessary covered services:</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586000002"> </span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (1)  Physician services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:02"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:02</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (2)  Inpatient</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> and </span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">outpatient hospital services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:03"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:03</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (3)  Home health services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:05"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:05</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (4)  Screening services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:11"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:11</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (5)  Clinic services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:13"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:13</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (6)  Ambulatory surgical center services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:28"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:28</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (7)  Medical equipment services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:29"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:29</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (8)  Organ transplants listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:31"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:31</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (9)  School district services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:37"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:37</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (10)  Mental health services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:41"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:41</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">;</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (11)  Federally qualified health center and rural health center services listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:44"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:44</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">; and</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    (12)  Diabetes </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">self-management training</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> listed in chapter </span><a href="https://sdlegislature.gov/Rules?Rule=67:16:46"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">67:16:46</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">.</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586000002"> </span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001">Source:</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> 20 SDR 135, effective February 22, 1994; 30 SDR 115, effective February 4, 2004; 46 SDR 50, effective October 10, 2019</span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">; 49 SDR 21, effective September 12, 2022</span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">.</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001">General Authority:</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">28-6-1</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">.</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">    </span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000001">Law Implemented:</span><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586C0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=28-6-1"><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0-000003">28-6-1</span></a><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">(1)(4)</span><span class="s56821ea7-35d3-4f65-b31b-90b929adb586C0">.</span></p><p dir="ltr" class="s56821ea7-35d3-4f65-b31b-90b929adb586P0"><span xml:space="preserve" class="s56821ea7-35d3-4f65-b31b-90b929adb586000002"> </span></p></div></body></html>