Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 17 - MEDICAL SUPPLIERS
Section 317:30-5-211.12 - Oxygen rental
Current through Vol. 42, No. 1, September 16, 2024
A monthly rental payment is made for rental of liquid oxygen systems, gaseous oxygen systems and oxygen concentrators. The rental payment for a stationary system includes all contents and supplies, such as, regulators, tubing, masks, etc., that are medically necessary. An additional monthly payment may be made for a portable liquid or gaseous oxygen system based on medical necessity.
(1) Stationary oxygen systems and portable oxygen systems are covered items for members residing in their home and in any setting in which normal life activities take place except for a hospital, long-term care facility, intermediate care facility for individuals with intellectual disabilities, or any other setting in which payment is or could be made under Medicaid for inpatient services that include room and board.
(2) For members who meet medical necessity criteria, SoonerCare covers portable liquid or gaseous oxygen systems. Payment for both oxygen contents used with stationary oxygen equipment and oxygen contents used with portable oxygen equipment is included in the monthly payments for oxygen and oxygen equipment. The need for a portable oxygen system must be stated on the CMN. A portable system that is used as a backup system only is not a covered item.
(3) When four(4) or more liters of oxygen are medically necessary, an additional payment will be paid up to one hundred and fifty percent (150%) of the allowable for a stationary system when billed with the appropriate modifier.
Added at 24 Ok Reg 2890, eff 7-1-07 (emergency); Added at 25 Ok Reg 1161, eff 5-25-08; Amended at 27 Ok Reg 628, eff 14-13-10 (emergency); Amended at 27 Ok Reg 1451, eff 6-11-10
