OK: Anesthesia & Dental Coverage (2026-05)

Bulletin 2026-05 notifies all health insurers licensed in Oklahoma of two legislative changes effective November 1, 2026. SB 1443 mandates that health benefit plans consider patient physical status (using ASA physical status modifiers P3, P4, P5 with base unit values of 1, 2, and 3 respectively) and the complexity and urgency of care when determining necessity and payment for anesthesia services. This requires insurers to update reimbursement systems to pay physical status modifiers according to specified base unit values. SB 1942 amends the definition of Covered services under 36 O.S. § 7301(B)(1) to mean services reimbursed under the applicable subscriber agreement, notwithstanding contractual limitations on subscriber benefits, potentially expanding the scope of reimbursable dental services. Both changes require immediate implementation as the effective date has already passed.

Source: https://www.oid.ok.gov/bulletin-no-2026-05/