MedicaidCoverageMedium impact
Provider Letter 2023-04: RE: Low-Dose Computed Tomography (LDCT) Lung Cancer Screening
Oklahoma SoonerCare·OK · Family Medicine, Internal Medicine, Pulmonology +2 more·Provider Letter
Effective date
Mar 2, 2023
We identified it
Jun 20, 2026
Summary
SoonerCare (Oklahoma Medicaid) has updated eligibility criteria for Low-Dose Computed Tomography (LDCT) lung cancer screening, expanding the age range to 50-80 years and reducing the smoking requirement to 20 cigarettes per day for 20+ years. Prior authorization is required for the screening, and first-time patients must receive a documented counseling and shared decision-making visit.
Action Required
Immediately: Update intake forms and EMR templates to capture new LDCT eligibility criteria (ages 50-80, current smokers or former smokers quit ≤15 years, 20+ cigarettes/day for 20+ years). Staff must ensure prior authorization is obtained before scheduling LDCT screenings. For first-time screenings, schedule mandatory counseling visit with shared decision-making documentation including eligibility determination, benefits/risks discussion, adherence importance, and smoking cessation counseling. Reference the coding and reimbursement information link provided in the policy.