Okla. Admin. Code § 317:30-5-1083

Current through Vol. 42, No. 4, November 1, 2024

Section 317:30-5-1083 - Coverage by category

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.

Okla. Admin. Code § 317:30-5-1083

Adopted by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/14/2020

Amended by Oklahoma Register, Volume 38, Issue 17, May 17, 2021, eff. 4/14/2021

Amended by Oklahoma Register, Volume 39, Issue 24, September 1, 2022, eff. 9/12/2022