OHCA Policies and Rules

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317:30-5-900.Eligible providers
[Issued 1-05-95]
The mammographer must be Medicare certified and have accreditation by the American College of Radiology for Mammography. Providers must have a current contract on file with the Oklahoma Health Care Authority.

317:30-5-901.Coverage by category
[Revised 12-01-06]
(a) Adults. Medically necessary screening mammography is a covered benefit. Additional follow-up mammograms are covered when medically necessary.
(b) Children. Coverage for children is the same as for adults.

317:30-5-902.Vocational rehabilitation [REVOKED]
[Revoked 6-27-02]

317:30-5-903.Individuals eligible for Part B of Medicare
[Revised 7-1-02]
Payment is made utilizing the Medicaid allowable for comparable services.

317:30-5-904.Covered procedures [REVOKED]
[Revoked 06-25-06]

[Issued 1-05-95]
Reimbursement to mammographers will be based on the current allowed charge for radiologic procedures.

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.