Oklahoma Complete Health Medicaid Prior Authorization Requirements Changes No Longer Effective November 1st, 2024
Date: 10/23/24
We will no longer implement the prior authorization for psychological testing we previously shared in September 2024. Oklahoma Complete Health will re-evaluate those services and share an update with you in the upcoming months.
The notification pertains to the following services below.
96130- Evaluation of Psychological Test, First hour
96131-Evaluation of Psychological Test, Each Additional Hour
96132-Evaluation of Neuropsychological Test, First Hour
96133-Evaluation of Neuropsychological Test, Each Additional Hour
96136-Administration of Psychological or Neuropsychological Test, First 30 Minutes
96137-Administration of Psychological or Neuropsychological Test, Each Additional 30 Minutes
96138-Adminstration of Psychological or Neuropsychological Test by Technician, First 30 Minutes
96139-Adminstration of Psychological or Neuropsychological Test by Technician, Each Additional 30 Minutes
96146-Admistration of Psychological or Neuropsychological Test by Single Standardized Instrument via Electronic Platform with Automated Result
Please continue to follow standard billing practices.
It is the ordering/prescribing provider’s responsibility to determine which specific codes require prior authorization.
Please verify every member’s eligibility and benefits prior to rendering services to them. Payment, regardless of authorization, is contingent on the member’s eligibility at the time service is rendered. Non-Par Providers and facilities require authorization for all services except where indicated.
The codes listed in this document represent the national, standard code sets. Inclusion or exclusion of a code does not constitute or imply subscriber coverage or provider reimbursement. Please refer to your contract with Oklahoma Complete Health to determine all contracted/covered codes for each membership group. Please refer to the Medicaid Fee Schedule and the Billing and Procedure Coding Guide for a list of approved modifier codes.
For a complete list of CPT/HCPCS codes, please use the Pre-Auth Check Tool.
Questions?
If you have any questions, please call Oklahoma Complete Health Provider Services at 1-833-752-1664 or visit the Find Your Provider Engagement Administrator tool to confirm the individual supporting your specialty and region. We encourage you stay up to date on Oklahoma Complete Health provider notices by reviewing and bookmarking Provider News.