Library: Policy

317:30-5-65. Ancillary Services

Revised 1-1-10

     Ancillary services are those items which are not considered routine services.  Ancillary services may be billed separately to the SoonerCare program, unless reimbursement is available from Medicare or other insurance or benefit programs.  Coverage criteria, utilization controls and program limitations are specified in Part 17 of OAC 317:30-5.  Ancillary services are limited to the following services:

• (1) Services requiring prior authorization:

• (A) Ventilators and supplies.

• (B) Total Parenteral Nutrition (TPN), and supplies.

• (C) Custom seating for wheelchairs.

• (D) Enteral feeding.

• (2) Services not requiring prior authorization:

• (A) Permanent indwelling or male external catheters and catheter accessories.

• (B) Colostomy and urostomy supplies.

• (C) Tracheostomy supplies.

• (D) Prescription drugs, laboratory procedures, and x-rays.