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SERVICE SCOPE OF BENEFIT (ANNUAL) Including but not limited to: Preventive Services Covered when ordered by a health plan physician/provider. Services include homemaker services, minor environmental modifications, physical therapy evaluation and services, and personal care services. EPSDT Services Provided to all children and young adults up to age twenty-one (21). Includes tracking, follow- up and outreach to children for initial visits, preventive visits, and follow-up visits. Includes inter-periodic screens as medically indicated. Includes multi-disciplinary evaluations and treatment, including, PT/OT/ST, for children with significant disabilities or developmental delays. Emergency Room Service and Emergency Transportation Services Covered both in- and out-of-State, for Emergency Services or when authorized by an MCO Provider, or in order to assess whether a condition warrants treatment as an emergency service. Nursing Home Care and Skilled Nursing Facility Care Covered when ordered by an MCO physician/provider. For Rhody Health Partners/Expansion members, the Contractor payments are limited to thirty (30) consecutive days. All skilled and custodial care covered. Contractor is responsible for notifying the State to begin disenrollment process. For RIte Care members, please refer to stop-loss provisions. School-Based Clinic Services Covered for RIte Care members as Medically Necessary at all designate sites. Services of Other Practitioners Covered if referred by an MCO physician or APP. Practitioners certified and licensed by the State of Rhode Island including social workers, licensed dietitians, psychologists and licensed nurse midwives.