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317:30-5-664.7.Dental services provided by Health Centers
[Revised 06-25-11]
(a) Adults. The Health Center core service benefit to adults is intended to provide services requiring immediate treatment, relief of pain and/or extraction and is not intended to restore teeth. For scope of services for individuals eligible under other program categories, refer to OAC 317:30-5-696. Core services are limited to treatment for conditions such as:
(1) Acute infection;
(2) Acute abscesses;
(3) Severe tooth pain; and
(4) Tooth re-implantation, when clinically appropriate.
(b) Children. Medically necessary dental services for children are covered.
(c) Exclusions and Limitations. Other medically necessary dental services which are not considered core services may be billed by the HealthCenter utilizing the current SoonerCare fee schedule.
(1) Smoking and tobacco use cessation is a covered service for adults and children and is separately reimbursable. Refer to OAC 317:30-5-2.
(2) Refer to OAC 317:30-5-695 for other specific coverage, exclusions and prior authorization requirements.(d) Health Centers must submit all claims for SoonerCare reimbursement for dental services on the American Dental Association (ADA) form.

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.