(a) Adults.  Outpatient Behavioral Health Services in Therapeutic Foster settings are not covered for adults.

(b) Children.  Outpatient behavioral health services are authorized in therapeutic foster care settings for certain children and youth by the designated agent of the Oklahoma Health Care Authority.  The children and youth authorized for services in this setting have special psychological, social and emotional needs, requiring more intensive, therapeutic care than can be found in the traditional foster care setting. The designated children and youth must continually meet medical necessity criteria to be eligible for coverage in this setting.  The medical necessity criteria are continually met for initial requests for services and all subsequent requests for services/ extensions.  Medical necessity criteria is delineated in the OHCA Behavioral Health Provider Manual.