(1) Outpatient hospital services do not include:

(a) services excluded from coverage by the Medicaid program under ARM 37.85.207;

(b) exercise programs and programs primarily educational in nature, including but not limited to:

(i) cardiac rehabilitation exercise programs prior to January 1, 2006;

(ii) nutritional programs;

(iii) independent exercise programs, such as pool therapy, swim programs, or health club memberships;

(iv) pulmonary therapy prior to January 1, 2006;

(c) outpatient physical therapy, occupational therapy, and speech therapy services that are primarily maintenance therapy as defined in ARM 37.86.601;

(d) experimental or investigational services such as the use of off-label drugs where this usage is not a national standard of practice, or non-FDA-approved use of drugs, biologicals, and devices;

(e) services that do not comply with national standards of medical care; and

(f) outpatient hospital services provided outside the borders of the United States will not be covered or reimbursed by the Montana Medicaid program.