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

(a)   As described in 42 CFR 136.11(a), the I/T/U services may include hospital and medical care, dental care, public health nursing,preventive care (including immunizations).

(b)   Further, 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. Provider contracts must meet the provider participation requirements found at OAC 317:30-5-1096.

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

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

(5)   Public health nursing services, within the scope of their licensure, 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.

(6)   Visiting nurse services to the homebound;

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

(8)   Dental services.

[Source: Added at 23 Ok Reg 2575, eff 6-25-06; Amended at 25 Ok Reg 2698, eff 7-25-08; Amended at 26 Ok Reg 3025, eff 7-21-09 (emergency); Amended at 27 Ok Reg 931, eff 5-13-10; Amended at 28 Ok Reg 16, eff 8-13-10 (emergency); Amended at 28 Ok Reg 1435, eff 6-25-11; Amended at 33 Ok Reg 837, eff 9-1-16]