OHCA Policies and Rules
To be eligible for payment as a laboratory/pathology service, the service must be:
(1) Ordered and provided by or under the direction of a physician or other licensed practitioner within the scope of practice as defined by state law;
(2) Provided in a hospital or independent laboratory;
(3) Directly related to the diagnosis and treatment of a medical condition;
(4) Authorized under the laboratory's CLIA certification; and
(5) Considered medically necessary as defined in OAC 317:30-3-1(f) and 317:30-5-20.
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.