South Dakota § 58-17-158 Authorization, prior approval, and other care management requirements--Annual maximum benefit.

South Dakota Statutes

§ 58-17-158 — Authorization, prior approval, and other care management requirements--Annual maximum benefit.

South Dakota·Title 58 INSURANCE·Ch. 58-13 HEALTH INSURANCE POLICIES

Coverage for an applied behavior analysis may be subject to pre-authorization, prior approval, and other care management requirements including limits on the number of individual visits a person may make for applied behavior analysis subject to the general care management provisions of the plan, and may be subject to dollar limits, deductibles, copayments, or coinsurance provisions that apply to other medical or surgical services covered under the policy. The coverage for applied behavior analysis shall provide an annual maximum benefit that may not be less than the following:

(1)Through age 6 $36,000 (2) Age 7 through age 13 $25,000 (3) Age 14 through age 18 $12,500

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Coverage for an applied behavior analysis may be subject to pre-authorization, prior approval, and other care management requirements including limits on the number of individual visits a person may make for applied behavior analysis subject to the general care management provisions of the plan, and may be subject to dollar limits, deductibles, copayments, or coinsurance provisions that apply to other medical or surgical services covered under the policy. The coverage for applied behavior analysis shall provide an annual maximum benefit that may not be less than the following: (1) Through age 6 $36,000 (2) Age 7 through age 13 $25,000 (3) Age 14 through age 18 $12,500

South Dakota § 58-17-158 (Authorization, prior approval, and other care management requirements--Annual maximum benefit.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.