Global Messages

Provider types: All

OHCA has opened coverage for the following COVID-19 monoclonal antibodies and administration when used in accordance with the emergency use authorization from the FDA. Monoclonal antibody infusion is reimbursable when provided in a hospital outpatient department or physician’s office experienced in infusion services. Due to the risk of anaphylaxis, treatment should only be administered in settings where health care providers have immediate access to medications to treat a severe infusion reaction and the ability to activate the emergency medical system as needed.

• Q0239 – Injection, bamlanivimab, 700 mg (Eli Lilly) (effective date 11/09/2020)
• M0239 – Intravenous infusion, bamlanivimab-includes infusion and post administrative monitoring (Eli Lilly) (effective date 11/09/2020)
• Q0243 – Injection, casirivimab and imdevimab, 2400 mg (Regeneron) (effective date 11/20/2020)
• M0243 – Intravenous infusion, casirivimab and imdevimab includes infusion and post administrative monitoring (Regeneron) (effective date 11/20/2020)
• Q0245 – Injection, bamlanivimab and etesevimab, 2100 mg (Eli Lilly) (effective date 2/9/2021)
• M0245 – Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring (Eli Lilly) (effective date 2/9/2021)

If you have any questions, please call the OHCA provider helpline at 800-522-0114.

Provider Types/Specialties: 03/030

Effective March 1, 2021, the Oklahoma Healthcare Authority (OHCA) will only be accepting electronic submissions for PASRR Level I (LTC-300R) and Level II. It will be the responsibility of the nursing facility or provider to submit the Level I and Level II in a timely manner. Phone calls to OHCA Psych/ID analysts should be reserved for questions such as, but not limited to, 30 day exempted hospital discharges that are about to lapse and require a Level II PASRR, seven-day emergency PASRR requests, PASRR policy, questions about quarantine due to COVID-19 and Level I corrections.

Please contact the OHCA internet help desk at 800-522-0114, select option 1 for provider, enter your provider number, select option 2 for the internet helpdesk and then notify them that you have experienced a technical issue while submitting your PASRR Level I (LTC300R) electronic form. For questions concerning the PASRR Level II electronic submission form, please contact the behavioral health unit at 405-522-7597, select option 1 for provider, option 6 for prior authorizations and option 2 to reach inpatient behavioral health. The PASRR Level II electronic form is located at https://oklahoma.gov/ohca/providers/types/behavioral-health-and-substance-abuse-services/behavioral-health-and-substance-abuse-services.html, under templates/forms.

Please note: Your provider number was given to you upon contracting with OHCA. Please contact your business office to obtain a copy of this if you do not have it. After you select option 1 for provider, please be sure to listen to the recording completely as it will tell you how to enter the alphabetical letter at the end of your provider number.

Provider Types / Specialties: 270-275, 080

According to OHCA policy OAC 317:30-5-696(J)iii, prior authorization is required for members who have a treatment plan requiring more than two (2) anterior and/or any posterior root canals.  Two (2) or fewer anterior and/or posterior root canals within a twelve month period, will not require prior authorization. 

Numeric Provider Types:  01

Numeric Provider Specialties: 

Global Message Body: Hospital providers who wish to bill for services provided in a psychiatric or rehabilitation unit must do so using a separate provider number by completing an addendum to their hospital contract. The addendum to hospital contracts for psych and rehab units can now be accessed online at https://oklahoma.gov/ohca/providers/provider-enrollment.html.

The US Dept. of Health and Human Services has extended the public health emergency through April 21, 2021. 

The public health emergency renewal is posted at: https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-07Jan2021.aspx.

What does this mean for SoonerCare providers and members?

• Expanded use of telehealth services through April 30, 2021 for most SoonerCare services.
• OHCA and DHS will not terminate SoonerCare coverage for members during this time.
• No cost sharing for testing or treatment of COVID-19 for SoonerCare members.
• Some medicines may be prescribed for 90 days to reduce trips to the pharmacy.

PV Specialties: 087, 120, 126, 145, 170, 171, 173, 174, 175, 179, 182

Provider letter 2021-02 informs providers about the reimbursement for the coverage of services that are rendered by physical therapy, occupational therapy, speech-language pathology therapy assistants and speech-language pathology clinical fellows. Please post all comments by close of business Monday, Feb. 8, 2021, via the Oklahoma Health Care Authority policy change blog. Thank you.

PV Specialties: 634

Provider letter 2021-01 informs providers about coverage for adults in a psychiatric hospital. Please post all comments by close of business Monday, Feb. 8, 2021, via the Oklahoma Health Care Authority policy change blog. Thank you.