MedicaidCoverageMedium impact
Provider Letter 2023-16: RE: Coverage for Diabetes Self-Management Education & Support (DSMES) Services
Oklahoma SoonerCare·OK · Endocrinology, Family Medicine, Internal Medicine·Medical Policy
Effective date
Sep 1, 2023
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid (SoonerCare) now covers Diabetes Self-Management Education & Support (DSMES) services for members with Type I or II diabetes. Coverage includes up to 10 hours in the first 12 months (1 hour individual, 9 hours group instruction) and 2 hours individual instruction per calendar year thereafter. Providers must obtain a separate SoonerCare contract and work under an accredited DSMES program.
Action Required
Immediately: Providers offering diabetes education must obtain a separate SoonerCare contract for DSMES services and enroll as a DSMES group first, then as an individual. Ensure all diabetes educators hold CDCES or BC-ADM certification, or are RD/RN/pharmacists with DSMES training. Contact provider enrollment at Providerenrollment@okhca.org or 800-522-0114, option 5 to begin contracting process.