Current through Vol. 42, No. 1, September 16, 2024
(a)
Definition. Portable dental unit means a non-facility in which
dental equipment used in the practice of dentistry is transported to and used
on a temporary basis at an out-of-office location at either group homes for
juveniles or public and private schools.
(b)
Eligible providers. For
dental services provided at a portable dental unit to be eligible for
SoonerCare reimbursement, a dental group shall meet all applicable requirements
set forth in the Oklahoma Board of Dentistry rules, the Oklahoma State Dental
Act (59 O.S., Ch. 7), and the requirements in this Section, including but not
limited to, all licensing and permitting requirements.
(1) All dentists working at a portable dental
unit shall be currently licensed in good standing with the Oklahoma Board of
Dentistry. All other contracted providers of the dental group, working at a
portable dental unit, shall meet all credentialing/certification requirements,
as per their specialty. In addition, all members of the dental group working at
a portable dental unit shall comply with the requirements at Oklahoma
Administrative Code (OAC)
317:30-5-695.
(2) The license or permit (or a photocopy of
the license or permit) of every individual provider shall be prominently
displayed at the portable dental unit site, pursuant to Title of 59 O.S. §
328.21.
(3) In accordance with OAC
317:30-5-695.1, every dental
group providing services at a portable dental unit must be fully contracted
with the OHCA as a dental group provider.
(4) Every individual dentist practicing at a
portable dental unit must be fully contracted with the OHCA as a
dentist.
(5) Dental groups and
individual providers providing dental services at a portable dental unit shall
comply with all state and federal Medicaid laws, including, but not limited to,
OHCA administrative rules, the Code of Federal Regulations, and the Oklahoma
State Medicaid Plan.
(c)
Coverage. Portable dental unit services are only available for
SoonerCare-eligible individuals under the age of twenty-one (21) and limited to
the services noted in (1) through (3) of this Subsection. All portable dental
units must have a SoonerCare-contracted, Oklahoma-licensed dentist onsite to
supervise all other portable dental unit staff. Coverage for dental services
provided to children/adolescents at a portable dental unit is limited to:
(1) One (1) fluoride application per member
per twelve (12) months;
(2) One (1)
dental screening annually that is performed by a SoonerCare-contracted,
Oklahoma-licensed dentist; and
(3)
Dental sealants on tooth numbers 2, 3, 14, 15, 18, 19, 30, and 31. The OHCA
will not reimburse the application of dental sealants for a given OHCA member
more than once every thirty-six (36) months, regardless of whether the services
are provided at a portable dental unit, or at some other authorized place of
service.
(d)
Post
Care. Each member receiving dental care at a portable dental unit must
receive an information sheet at the end of the visit. The information sheet
must contain:
(1) The name of the dentist,
dental hygienist, and/or dental assistant who provided the dental services at
the portable dental unit;
(2) A
valid business telephone number and/or other emergency contact number for the
dental group and/or dentist that provided the dental services at the portable
dental unit;
(3) A listing of the
treatment rendered, including, when applicable, billing codes, fees, and tooth
numbers;
(4) A description of any
follow-up treatment that is needed or recommended; and
(5) Referrals to specialists or other
dentists if the portable dental unit providers were unable to provide the
necessary treatment and/or additional care is needed.
(e)
Billing. Refer to OAC
317:30-5-704 through
317:30-5-705 for billing
instructions and guidelines. Please note that for any dental service provided
through a portable dental unit that is billed to SoonerCare, the appropriate
place of service must be identified on the claim to receive
reimbursement.
