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.
Added at 37 Ok Reg 521, eff 1-6-20 (emergency)
Added at 37 Ok Reg 1543, eff 9-14-20
Amended at 38 Ok Reg 747, eff 4-14-21 (emergency)
Amended at 39 Ok Reg 1493, eff 9-12-22