Behavioral Health Services

A basic package of primary and preventive behavioral services, such as screenings for depression, anxiety and substance abuse, is available to every SoonerCare member without prior authorization. This is for services delivered by Patient-Centered Medical Homes, Indian/Tribal/Urban (I/T/U) Clinics and Federally Qualified Health Centers. Other specialty providers, (i.e., public and private outpatient behavioral health agencies and private independent licensed practitioners) must complete preadmission/prior authorization forms.

Outpatient behavioral health service rates and codes, prior authorizations and training information can be found on the Oklahoma Department of Mental Health & Substance Abuse’s PICIS Data Collaboration page.

• SoonerCare-Approved Behavioral Health Screening Tools and Guidelines  
• Certified Community Behavioral Health Clinics (CCBHC)
• OTP Billing
• Telehealth

• Part 1 – General Scope And Administration
• Part 21 – Outpatient Behavioral Health Services (All Sections) 
• Part 25 – Psychologists  
• Part 26 – Licensed Behavioral Health Providers    

• Electroconvulsive Therapy Guidelines
• ECT Prior Authorizations

Inpatient hospital and residential services for SoonerCare members must have prior authorizations before the service is provided. Telephonic initial and concurrent reviews to determine medical necessity criteria (view Provider Manual) are required. 

• 1-1 Staffing Per Diem Prior Authorization Request
• Adult Ages 18-64 Inpatient Medical Detox PA Request Form
• Adult Ages 18-64 Inpatient Psychiatric PA Request Form
• Behavioral Health Prior Authorization Correction Request  
• BH Specialty Add-On Payment Prior Authorization Requests
• Child/Adolescent Under 18 Inpatient Admission PA Request Form
• Child/Adolescent Under 18 Inpatient Extension PA Request Form
• Conditions of Treatment Participation Inpatient Psych Programs for Children
• Inpatient Discharge Notification Form
• Instructions for Using Adult Ages 18-64 PA Request Forms
• Non-Verbal Per Diem Prior Authorization Request
• Psychiatric Residential Treatment Facility Attestation

• Part 6 – Inpatient Psychiatric Services

• SUD Residential Level of Care Provider Instruction for IMD Waiver
• Halfway House, Residential SUD, Med Detox OHCA/DMH Billing Guide – effective 7/1/22

• TFC Rates and Codes
• TFC-ITFC Notice of Admission PA Request
• TFC-ITFC Extension PA Request  

• Part 83 – Therapeutic Foster Care
• Part 84 - Intensive Treatment Family Care

• Opiate Prescribing Guidelines  
• Oklahoma Pediatric Psychotropic Medication Resource Guide

• PASRR
• Screening for Level II PASRR

• Child Health/EPSDT

• Part 30 – Applied Behavior Analysis (ABA) Services

• SoonerCare Provider Contracts  
• Behavioral Health Accrediting Organizations  
• Licensing Boards  
• Provider Certification - ODMHSAS  
• PRTF Survey (Cost Report)

• Claims Tools
• Entering NDC with HCPCS
• SoonerCare Provider Portal - Medicaid on the Web Training Manual