Oklahoma Administrative Code
Title 317 - Oklahoma Health Care Authority
Chapter 30 - Medical Providers-Fee for Service
Subchapter 5 - Individual Providers and Specialties
Part 64 - CLINIC SERVICES
Section 317:30-5-575 - General information
Universal Citation: OK Admin Code 317:30-5-575
Current through Vol. 42, No. 1, September 16, 2024
(a) Clinic services. Clinic services means preventive, diagnostic, therapeutic, rehabilitative, or palliative services that are furnished by a facility that is not part of a hospital but is organized and operated to provide medical care to outpatients. The term includes the following services furnished to outpatients:
(1) Services furnished at the clinic by or
under the direction of a physician or a dentist.
(2) Services furnished outside the clinic, by
clinic personnel under the direction of a physician, to an eligible individual
who does not reside in a permanent dwelling or does not have a fixed home or
mailing address.
(3) Teleheath and
audio-only health service delivery requires either the provider or the member
to be located at the freestanding clinic that is providing services pursuant to
42 Code of Federal Regulations (CFR) § 440.90. Refer to section Oklahoma
Administrative Code (OAC)
317:30-3-27 for telehealth policy
and OAC 317:30-327.1 for audio-only telecommunication policy.
(b) Prior authorization. OHCA requires prior authorization for certain procedures to validate the medical need for the service.
(c) Medical necessity. Medical necessity requirements are listed at OAC 317:30-3-1(f).
Added at 28 Ok Reg 1394, eff 6-25-11
Disclaimer: These regulations may not be the most recent version. Oklahoma may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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