Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 109 - DIABETES SELF-MANAGEMENT EDUCATION AND SUPPORT
Section 317:30-5-1083 - Coverage by category
Current through Vol. 42, No. 1, September 16, 2024
The purpose of DSMES services must be to provide the member with the knowledge, skill, and ability necessary for diabetes self-care.
(1) Adults. Payment is made for medically necessary DSMES provided by eligible providers described in OAC 317:30-5-1081. Refer to OAC 317:30-5-1082 for units of DSMES training allowed.
(2) Children/adolescents. Payment is made for medically necessary DSMES for members under twenty-one (21) years of age provided by eligible providers described in OAC 317:30-5-1081. DSMES coverage for children is the same as for adults. Additional DSMES services may be covered under EPSDT provisions if determined to be medically necessary.
