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MedicaidPrior AuthMedium impact

Provider Letter 2021-01: Added Coverage for Adults in a Psychiatric Hospital

Oklahoma SoonerCare·OK · Psychiatry·Medical Policy
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Oklahoma Medicaid (SoonerCare) now covers inpatient psychiatric services and detoxification/withdrawal management for adults age 21 and above in psychiatric hospitals or psychiatric units of general hospitals. Prior authorization is required for all admissions to these facilities for covered members.

Action Required

Action needed
Immediately: Billing team must obtain prior authorization for all SoonerCare members age 21+ admitted to inpatient psychiatric units or psychiatric hospitals for psychiatric services or detox/withdrawal management. Download new adult prior authorization request forms from OHCA's behavioral health services website. Update billing workflows to verify prior auth before submitting claims. Claims without prior authorization will be denied.