1. (a) If the Center chooses to provide other Oklahoma Medicaid State Plan covered health services which are not included in the Health Center core service definition in OAC 317:30-5-661.1, the practitioners of those services are subject to the same program coverage limitations, enrollment, and billing procedures described by the OHCA, and these services (e.g., home health services) are not included in the Prospective Payment System settlement methodology in OAC 317:30-5-664.12.

2. (b) Other medically necessary health services that will be reimbursed at the fee-for-service rate include, but are not limited to:

   1. (1) Dental services (refer to OAC 317:30-5-696) except for primary preventive dental services;
   2. (2) Eyeglasses (refer to OAC 317:30-5-431, 317:30-5-432.1 and 317:30-5-451);
   3. (3) Clinical lab tests performed in the Center lab (other than the specific laboratory tests set out for Health Centers' certification and covered as Health Center services);
   4. (4) Technical component of diagnostic tests such as x-rays and EKGs (interpretation of the test provided by the Center physician is included as physician professional services);
   5. (5) Durable medical equipment (refer to OAC 317:30-5-210);
   6. (6) Transportation by ambulance (refer to OAC 317:30-5-335);
   7. (7) Prescribed drugs (refer to OAC 317:30-5-70);
   8. (8) Prosthetic devices (other than dental) which replace all or part of an internal body organ (including colostomy bags) and supplies directly related to colostomy care and the replacement of such devices;
   9. (9) Specialized laboratory services furnished away from the clinic;
   10. (10) Psychosocial rehabilitation services (refer to OAC 317:30-5-241.3);
   11. (11) Behavioral health related case management services (refer to OAC 317:30-5-241.6); and
   12. (12) Applied behavior analysis (ABA) (refer to OAC 317:30-3-65.12).
   13. (13) Diabetes self-management education and support (DSMES) services (refer to OAC 317:30-5-1080 through 317:30-5-1084).
   14. (14) Long-acting reversible contraceptive devices (devices are not considered part of the FQHC encounter rate and can be billed separately).

Added at 23 Ok Reg 3183, eff 6-7-06 (emergency)

Added at 24 Ok Reg 2105, eff 6-25-07

Amended at 33 Ok Reg 804, eff 9-1-16

Amended at 34 Ok Reg 674, eff 9-1-17

Amended at 36 Ok Reg 1099, eff 7-1-19 (emergency)

Amended at 37 Ok Reg 514, eff 1-6-20 (emergency)

Amended at 37 Ok Reg 1492, eff 9-14-20

Amended at 38 Ok Reg 1043, eff 9-1-21

Amended at 39 Ok Reg 423, eff 12-30-21 (emergency)

Amended at 39 Ok Reg 1490, eff 9-12-22