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Part 37      ADVANCED PRACTICE NURSE

317:30-5-375.Eligible providers
[Revised 09-14-2020]

(a) The advanced practice registered nurse (APRN) must:

(1) Be licensed and in good standing in the state in which services are provided;

(2) Have completed an accredited graduate level advanced practice registered nursing education program approved by the board of nursing in the state in which services are provided; and

(3) Possess a current national certification by a national certifying body recognized by the board of nursing in the state in which services are provided.

(b) APRN services are limited to the scope of practice defined in 59 O.S. ' 567.3a and corresponding administrative rules at Oklahoma Administrative Code (OAC) 485:10-5-1 through 485:10-16-9. Rules regarding certified nurse midwives are referenced in OAC 317:30-5-225. APRNs who practice in states other than Oklahoma must be appropriately licensed in the state in which they practice. In addition, all providers must have a current contract on file with the Oklahoma Health Care Authority.


317:30-5-376.Coverage by category

[Revised 09-14-2020]

Payment is made to advanced practice registered nurses (APRNs) as set forth in this Section.

(1) Adults.  Payment for adults is made for primary care health services, within the scope of practice of an APRN and within the scope of the Oklahoma Health Care Authority (OHCA) medical programs.

(2) Children.  Payment for children is made for primary care health services, within the scope of practice of an APRN, to members under twenty-one (21) years of age, including Early and Periodic Screening, Diagnostic and Treatment (EPSDT) screening services.

(A) Payment is made to eligible providers for EPSDT services to members under twenty-one (21) years of age. Specific guidelines for the EPSDT program including the periodicity schedule are found in Oklahoma Administrative Code (OAC) 317:30-3-65 through 317:30-3-65.12.

(B) Comprehensive screening examinations are to be performed by a provider qualified under State law to furnish primary health care services.

(3) Individuals eligible for Part B of Medicare.  Payment is made utilizing the Medicaid allowable for comparable services.

 

 

 

317:30-5-377.Billing instructions [REVOKED]
[Revoked 6-27-02]


Disclaimer. The OHCA rules found on this Web site are unofficial. The official rules are published by the Oklahoma Secretary of State Office of Administrative Rules as Title 317 of the Oklahoma Administrative Code. To order an official copy of these rules, contact the Office of Administrative Rules at (405) 521-4911.