Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 113 - LIVING CHOICE PROGRAM
Section 317:30-5-1207 - Benefits for members ages sixteen (16) through eighteen (18) in a psychiatric residential treatment facility
Current through Vol. 42, No. 1, September 16, 2024
(a) Living Choice program participants, ages sixteen (16) through eighteen (18), may receive a range of necessary home and community based services for one(1) year after transitioning to the community from a psychiatric residential treatment facility (PRTF) setting. In order to be eligible for the Living Choice program, the member must:
(b) Services must be billed using the appropriate Healthcare Common Procedure Code System and must be medically necessary.
(c) All services must be necessary for the individual to live successfully in the community, must be documented in the individual care plan and require prior authorization.
(d) Services that may be provided to members transitioning from a PRTF are found in OAC 317:30-5-241.6(1)(B).
(e) Reimbursement will be for a monthly care coordination payment upon successful submission of a claim for one(1) or more of the covered services listed in OAC 317:30-5-96.3(e)(2).
