MedicaidAdministrativeMedium impact
Provider Letter 2023-22: RE: Overtime Payments & Private Duty Nursing
Oklahoma SoonerCare·OK · Pulmonology, Critical Care, Pediatrics·Provider Letter
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid (SoonerCare) now accepts electronic claims for Private Duty Nursing overtime services using the TU modifier, effective October 1, 2023. Overtime payment is only available for nursing staff providing services to members with tracheostomies or on ventilator life support for at least 6 hours daily.
Action Required
Immediately: Billing team must update system to accept TU modifier for Private Duty Nursing overtime claims for Oklahoma Medicaid members. Verify patient eligibility requires tracheostomy or ventilator dependence (6+ hours daily, excluding CPAP/BiPAP only). Submit overtime claims electronically using TU modifier for services over 40 hours per week. Contact OHCA provider helpline at 800-522-0114 with questions.