• Home health care - Limited to 100 visits per calendar year

• Home infusion therapy

• Hospice – Requires physician statement of life expectancy of six (6) months or less

• Durable Medical Equipment

• Out-patient mental health/substance abuse visits – Prior authorization is required for any visit exceeding the first fifteen (15) visits

• Chiropractic therapy – Prior authorization is required for any visits exceeding the first fifteen (15) visits

• Physical therapy – Prior authorization is required for any visits exceeding the first fifteen (15) visits.

To obtain prior authorization, please have your provider contact the Health Care Management Division at 405-717-8879 or toll free 1-800-543-6044, ext. 8879.

Failure to obtain prior authorization will result in a 10% penalty of the allowed amount.