Library: Policy

317:30-5-222. Reimbursement

Revised 2-21-23

(a) Counseling services must be billed using appropriate CPT codes and guidelines and must be medically necessary.  SoonerCare does not allow more than six units [thirty (30) minutes = one (1) unit] per pregnancy including twelve (12) months postpartum care.

(b) Genetic Counselors who are employed by or remunerated by another provider may not bill the SoonerCare program directly for services if that billing would result in duplicate payment for the same service.