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OHCA Policies and Rules

317:30-5-222. Reimbursement

[Revised 09-11-23]

(a) Counseling services must be billed using appropriate CPT codes and guidelines and must be medically necessary.  SoonerCare does not allow more than six units [thirty (30) minutes = one (1) unit] per pregnancy including twelve (12) months postpartum care.

(b) Genetic Counselors who are employed by or remunerated by another provider may not bill the SoonerCare program directly for services if that billing would result in duplicate payment for the same service.

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.