Okla. Admin. Code § 317:30-5-42.4

Current through Vol. 41, No. 19, June 17, 2024

Section 317:30-5-42.4 - Clinic/treatment room services; urgent care

(a) An outpatient hospital clinic is a non-emergency service providing diagnostic, preventive, curative and rehabilitative services on a scheduled basis.

(b) Urgent care payment is made for services provided in non-emergency clinics operated by a hospital. This payment does not include the professional charges of the treating physician, nurse practitioner, physician assistant or charges for diagnostic testing. A facility charge is also allowed when drug and/or blood are administered outpatient.

(c) Urgent Care services will not require a referral for SoonerCare Choice members however other claims will deny without a referral.

(d) Adults are limited to four clinic visits per month.

Okla. Admin. Code § 317:30-5-42.4

Added at 24 Ok Reg 317, eff 12-1-06 (emergency); Added at 24 Ok Reg 905, eff 5-11-07