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

SD Codified L § 58-17-158 (2019) (N/A)
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58-17-158. Authorization, prior approval, and other care management requirements--Annual maximum benefit. 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 $12,500Source: SL 2015, ch 250, § 5.

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§ 58-17-159 Qualifications of person performing or supervising applied behavior analysis .