Early Periodic Screening Diagnostic Treatment (EPSDT) Personal Care Services (PCS) - MEDICAID - LOUISIANA

This policy covers EPSDT Personal Care Services (PCS): medically necessary assistance with activities of daily living (eg, eating, toileting, grooming, bathing, dressing), transfers/locomotion, limited incidental household tasks for the beneficiary, accompaniment (not transport) to medical appointments, and medication prompting, billed in 15‑minute units. Coverage is limited to Humana Healthy Horizons Louisiana Medicaid members who are EPSDT‑eligible (birth through 20 years; medication prompting may be used for EPSDT‑eligible beneficiaries over 18), requires a prescription from an attending physician/APRN/PA, applies only when physical/cognitive limitations due to illness or injury necessitate care, excludes catheterization and routine household chores, is provided in the home or a medically necessary alternate location, and approved units cannot be banked or exceed authorization.

"Impairment is due to illness or injury (phrase in text: "to illness or injury; and")"