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317:30-5-376.Coverage by category

[Revised 01-06-2020]

Payment is made to advanced practice registered nurses 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 advanced practice registered nurse 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 advanced practice registered nurse, 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.

 

 

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.