(1) The following services are reimbursable targeted case management services for children and youth with special health care needs:

(a) comprehensive assessment and periodic reassessment;

(b) care plan development;

(c) care coordination and referral for other services; and

(d) monitoring and follow up.

(2) Monitoring must be at least once annually to determine if the following conditions are being met:

(a) services are being furnished in accordance with the child's care plan;

(b) services in the care plan are adequate; and

(c) changes in the needs or status of the child are reflected in the care plan.