SECTION 317:30-5-42.4. Clinic/treatment room services; urgent care

Latest version.

(a)   An outpatient hospital clinic is a non-emergency service providing diagnostic, preventive, curative and rehabilitative services on a scheduled basis.
(b)   Urgent care payment is made for services provided in non-emergency clinics operated by a hospital. This payment does not include the professional charges of the treating physician, nurse practitioner, physician assistant or charges for diagnostic testing. A facility charge is also allowed when drug and/or blood are administered outpatient.
(c)   Urgent Care services will not require a referral for SoonerCare Choice members however other claims will deny without a referral.
(d)   Adults are limited to four clinic visits per month.

[Source: Added at 24 Ok Reg 317, eff 12-1-06 (emergency); Added at 24 Ok Reg 905, eff 5-11-07]

                    
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