SECTION 317:30-5-1083. Coverage by category

Latest version.

  The purpose of DSMT services must be to provide the member with the knowledge, skill, and ability necessary for diabetes self-care.
(1)   Adults. Payment is made for medically necessary DSMT provided by a registered nurse (RN), registered dietitian (RD), or pharmacist certified as a diabetes educator, as described in OAC 317:30-5-1081.Refer to OAC 317:30-5-1082 for units of DSMT training allowed.
(2)   Children/adolescents. Payment is made for medically necessary DSMT for members under twenty-one (21) years of age provided by a RN, RD, or pharmacist certified as a diabetes educator, as described in OAC 317:30-5-1081. DSMT coverage for children is the same as for adults. Additional DSMT services may be covered under EPSDT provisions if determined to be medically necessary.

[Source: Added at 37 Ok Reg 521, eff 1-6-20 (emergency); Added at 37 Ok Reg 1543, eff 9-14-20]

                    
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