The Health Care Management Division is responsible for certification of the following services:
- Botox Injections (non-cosmetic)
- Chiropractic therapy –visits exceeding 20 per calendar year must be certified; limited to 60 visits per calendar year.
- Dental accidents
- Durable medical equipment (DME)
- Enteral feeding
- Hearing aids – covered only for dependent children up to age 18
- Home health care – may be approved for up to 100 visits per calendar year
- Home infusion therapy
- Hospice – requires physician statement of life expectancy of six months or less
- Mental Health Home Services – covered only for six biologically-based diagnoses (schizophrenia, bipolar disorder, manic depressive illness, major depressive disorder, panic disorder, obsessive-compulsive disorder, and schizo-affective disorder)
- Non-emergency ground or air ambulance
- Occupational therapy - visits exceeding 20 per calendar year must be certified; limited to 60 visits per year
- Oral Surgery – outpatient
- Orthotics and Prosthetics
- Outpatient hyperbaric oxygen therapy
- Outpatient mental health/substance abuse treatment – visits exceeding 15 per calendar year must be certified; limited to 26 visits per calendar year
- Physical therapy – Certification must be initiated and approved for visits exceeding 20 per calendar year; limited to 60 visits per calendar year
- Speech therapy
- Covered for restoring existing speech lost due to disease or injury. Therapy must be expected to restore the level of speech the participant had before the disease or injury.
- Not covered for learning disabilities or birth defects
- Limited to 60 visit per calendar year
- For ages 17 and younger, all Speech Therapy requires certification through the HealthChoice Health Care Management Unit
- For ages 18 and older, certification is not required.
- Temporomandibular Joint Dysfunction (TMD) treatment
- Visco supplementation injections of the knee
To obtain certification, please have your provider contact the Health Care Management Division at 1-405-717-8879 or toll-free 1-800-543-6044, ext. 8879.