MedicaidCoverageMedium impact
Provider Letter 2022-18: Re: Assessment/Evaluation and Testing Updated Guidance
Oklahoma SoonerCare·OK · Psychiatry·Provider Letter
Effective date
Sep 9, 2022
We identified it
Jun 20, 2026
Summary
Oklahoma Medicaid updated guidance for psychological evaluation and testing services, clarifying coverage requirements, billing procedures, and supervision rules. Key changes include specific documentation requirements for service plans, 8-hour annual testing limits, and proper use of base codes versus add-on codes for billing.
Action Required
Immediately: Billing team must update procedures for psychological testing claims to ensure proper use of base codes (first 60-minute evaluation and first 30-minute administration) followed by add-on codes only. Verify all testing services by psychological technicians are billed under supervising psychologist with 'HL' modifier. Update prior authorization tracking to enforce 8-hour annual limit per patient over age 3.