Okla. Stat. tit. 36, § 36-6060.11b: Reimbursement for benefits delivered through

behavioral health integration and psychiatric collaborative care

models.

A. For the purposes of this section:

1. “Behavioral health integration” means an approach to

delivering mental health care that improves the ability for primary

care providers to include mental and behavioral health screening,

treatment, and specialty care into their practice pursuant to

Current Procedural Terminology billing code 99484, as established by

the American Medical Association;

2. “Health benefit plan” means a plan as defined pursuant to

Section 6060.4 of Title 36 of the Oklahoma Statutes;

3. “Mental health and substance abuse disorder benefits” means

benefits for the treatment of any condition or disorder that

involves a mental health condition or substance abuse disorder,

including, but not limited to, those that fall under any of the

diagnostic categories listed in the mental disorders section of the

most recent edition of the International Classification of Diseases

or in the mental disorders section of the most recent version of the

Diagnostic and Statistical Manual of Mental Disorders;

4. “Oklahoma Medicaid Program” means the state program

administered by the Oklahoma Health Care Authority pursuant to

Section 1002 of Title 56 of the Oklahoma Statutes; and

5. “Psychiatric collaborative care model” means the evidence-

based, integrated behavioral health service delivery method

described pursuant to 81 C.F.R. 80230. The model shall include, but

not be limited to, the following Current Procedural Terminology

billing codes, as established by the American Medical Association:

a. 99492,

b. 99493, and

c. 99494.

B. 1. Any health benefit plan that is offered, issued, or

renewed in this state and that provides mental health or substance

abuse disorder benefits shall provide reimbursement for such

benefits that are delivered through the behavioral health

integration and psychiatric collaborative care models.

2. The Oklahoma Medicaid Program shall provide reimbursement

for such benefits that are delivered through the behavioral health

integration and psychiatric collaborative care models.

3. Plans offered, issued, or renewed in this state that provide

benefits under this subsection may deny reimbursement of any Current

Procedural Terminology code pursuant to paragraph 3 of subsection A

of this section due to medical necessity; provided, such medical

necessity determinations shall be in compliance with the federal

Paul Wellstone and Pete Domenici Mental Health Parity and Addiction

Equity Act of 2008, as amended, and its implementing and related

regulations, and in accordance with the utilization review

requirements pursuant to Section 6551 et seq. of Title 36 of the

Oklahoma Statutes and the review and denial of mental health and

substance abuse disorder treatments and services in Section 1250.5

et seq. of Title 36 of the Oklahoma Statutes.