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317:30-5-1099.I/T/U service limitations

[Revised 09-01-16]
   Service limitations governing the provision of all Oklahoma SoonerCare services will apply pursuant to Chapter 30 of the OHCA rules. In addition, the following limitations and requirements apply to services provided by I/T/U facilities:

(1) Multiple encounters. An I/T/U facility may bill for more than one encounter per 24 hour period under certain conditions.

(2) Behavioral Health services. Behavioral Health Services are limited to those services furnished to members at or on behalf of the I/T/U facility.

(3) Laboratory procedures. Laboratory procedures performed by an I/T/U outpatient facility (not an independently certified enrolled laboratory) on the same date of service are considered part of the health care practitioner's service and are included in the I/T/U encounter.


 

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.