North Dakota Department Of Health & Human Services Coverage Criteria
- North Dakota Department Of Health & Human Services prior authorization
- North Dakota Department Of Health & Human Services timely filing
- All North Dakota Department Of Health & Human Services policy updates
Latest North Dakota Department Of Health & Human Services coverage criteria updates8
- Coverage CriteriaClinical/Medical PolicyEff. 2007-03-01Gait Trainers/WalkersThis policy governs Medicaid coverage and service authorization for gait trainers and walkers used by members with impaired ambulation. It establishes medical necessity criteria, documentation requirements, equipment-specific billing guidance, and non-covered accessories.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyEff. 2007-03-01Power Operated Vehicle (POV) Coverage CriteriaThis policy section governs coverage of power operated vehicles (POVs) under the North Dakota Medicaid Durable Medical Equipment Manual. POVs are not covered.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyEff. 2007-03-01Pressure Reducing Support SurfacesThis policy governs Medicaid coverage and service authorization for pressure reducing support surfaces, including powered pressure reducing mattresses and air fluidized beds, when specified immobility, positioning, pressure-ulcer, and medical-necessity criteria are met.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyEff. 2007-03-01Standing Frame-Stander Coverage CriteriaThis policy governs Medicaid coverage and service authorization for standing frames and standers for members ages 0 through 20. It establishes medical-necessity, documentation, equipment, home-use, and non-covered-item requirements for providers requesting the equipment.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyEff. 2007-03-01TLSO/LSO Coverage CriteriaThis policy governs Medicaid coverage and documentation requirements for thoracolumbosacral and lumbosacral orthoses (TLSO/LSO). Coverage applies when the device is medically necessary for trunk mobility restriction, spinal healing, spinal or trunk weakness, or spinal deformity.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyCranial Remolding OrthosisThis policy governs coverage and service authorization for pediatric cranial remolding orthoses, including cranial bands or helmets billed under HCPCS S1040, for North Dakota Medicaid fee-for-service providers.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicySeat Lift Mechanism Coverage CriteriaThis policy governs Medicaid coverage and limitations for seat lift mechanisms prescribed for members with severe hip or knee arthritis or severe neuromuscular disease. It specifies medical-necessity criteria, documentation requirements, excluded equipment, and the replacement limit.All North Dakota Department of Health & Human Services updates
- Coverage CriteriaClinical/Medical PolicyUrological SuppliesThis policy governs Medicaid coverage and limitations for urological supplies, including catheters and external urinary collection devices, when members have permanent urinary incontinence or permanent urinary retention and applicable coverage criteria are met.All North Dakota Department of Health & Human Services updates
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Tool Description
Search North Dakota Department Of Health & Human Services coverage criteria and medical necessity requirements across 21,000+ policies from 170+ payers.
Search a drug (“Wegovy”), a procedure (“knee replacement”), or a policy name, then filter by payer, specialty, policy type, or effective year. Or start from the largest publishers: UnitedHealthcare coverage criteria and Cigna coverage criteria.
Each result links the full policy page, which lists the clinical requirements, covered codes, and effective dates from the source document.
Pair a criteria search with the prior authorization lookup for approval requirements, the timely filing lookup for claim deadlines, the live policy updates feed for the newest payer publications, and payer profiles for contacts and coverage context.
FAQ
Coverage criteria are the specific clinical requirements a payer sets for covering a drug, procedure, or service: diagnoses, symptom duration, prior treatments tried, age limits, and documentation. They are published inside medical policies and clinical criteria documents, and a claim or authorization that does not meet them is denied as not medically necessary.
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