Library: Policy

317:30-5-1091. Definition of I/T/U services

Revised 8-13-10

(a) As described in Title 42 of the Code of Federal Regulations (CFR) 136.11(a), the I/T/U services may include hospital and medical care, dental care, public health nursing and preventive care (including immunizations), and health examination of special groups such as school children.

(b) Further, Title 42 CFR 136.11(c) allows that the scope and availability of I/T/U services will depend upon the resources of the facility.

(c) I/T/U services may be covered when furnished to a patient at the clinic or other location, including a mobile clinic, or the patient's place of residence.

(d) I/T/U outpatient encounters include but are not limited to:

• (1) Physicians' services and supplies incidental to a physician's services;

• (2) Within limitations as to the specific services furnished, a doctor of dentistry or oral surgery, a doctor of optometry, or a doctor of podiatry [Refer to Section 1861(r) of the Act for specific limitations];

• (3) The services of a resident as defined in OAC 317:25-7-5(4) who meets the requirements for payment under SoonerCare and the supplies incidental to a resident's services;

• (4) Services of advanced practice nurses (APNs), physician assistants (PAs), certified nurse midwives (CNMs), or specialized advanced practice nurse practitioners;

• (5) Services and supplies incidental to the services of APNs and PAs (including services furnished by certified nurse midwives);

• (6) Public health nursing services include but are not limited to services in the following areas:

  • (A) Phlebotomy;

  • (B) Wound care;

  • (C) Public health education;

  • (D) Administration of immunizations;

  • (E) Administration of medication;

  • (F) Child health screenings meeting EPSDT criteria;

  • (G) Smoking and Tobacco Use Cessation Counseling;

  • (H) Prenatal, newborn and postpartum assessments, including case management services for first time mothers; and

  • (I) General health assessments and management of conditions such as tuberculosis, diabetes and hypertension.

• (7) Visiting nurse services to the homebound;

• (8) Behavioral health professional services and services and supplies incidental to the services of LBHPs; and

• (9) Dental services.