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• Nurse-midwife services;• Federally qualified health center (FQHC) services, and ambulatory services of an FQHCthat would be available in other settings;• Early and periodic screening, diagnostic, and treatment (EPSDT) services for childrenunder age 21. 15There are also optional services for which states may receive federal funding. Of the 34approved optional services, these are the most common:• Diagnostic services;• Clinic services;• Intermediate care facilities for the mentally retarded (ICFs/MR);• Prescribed drugs and prosthetic devices;• Optometrist services and eyeglasses;• Nursing facility services for children under age 21;• Transportation services;• Rehabilitation and physical therapy services;• Home and community-based care to certain people with chronic impairments. 16States determine the amount and duration of their Medicaid services within guidelines. Forexample, states may limit the number of hospital days or doctor visits covered, but tworestrictions apply. Limits must not interfere with producing a sufficient level of services toachieve the purpose of the benefits, and limits may not discriminate among beneficiaries basedon medical diagnosis or condition. States are generally required to provide comparableamounts, duration, and scope of services to all categorically needy and categorically relatedeligible groups. There are two exceptions to this: 1) medically necessary services underEPSDT that are included in the federal mandatory or optional benefits must be covered even ifthose services are not included in the state’s plan, and 2) states may request Medicaid waiversto pay for otherwise uncovered home and community-based services to people who mightotherwise be institutionalized. States have few limitations on the services that can be offeredunder waivers, as long as the services are cost-effective. Each Medicaid program generallymust allow beneficiaries to have informed choices between providers and to receive appropriateand timely care. 17Medicaid FinancesFederal MatchingThe federal share of the match for each state’s medical services under Medicaid is called theFMAP (Federal Medical Assistance Percentage) and is calculated from the average per capitaincome of the state compared to the U.S. average. A state with its per capita income at thenational average will have a FMAP of 55 percent; states with higher incomes will have a lowerFMAP and state with lower incomes will have a higher FMAP. The exact formula used is thefollowing: 18B-6