Or. Admin. Code § 410-146-0160 - Administrative Medical Examinations and Reports

(1) The Division may not reimburse administrative medical examinations and reports at an IHCP's IHS encounter rate. Administrative medical examinations and reports are not eligible under the Memorandum of Agreement (MOA). The Division shall reimburse providers for Administrative Examinations and Reports on a fee-for-service basis outside the IHS or cost-based encounter rate.

(2) AI/AN Health Care Facilities may be reimbursed for administrative medical examinations and reports when requested by a Department of Human Services branch office or approved by the Division. The branch office may request an Administrative Medical Examination/Report Authorization (OHP 729) to establish client eligibility for an assistance program or casework planning.

(3) Refer to OAR 410 division 150, Administrative Examination and Report Billing Services, for specific requirements. See Administrative Exams Supplemental Information guide for more detailed information on procedure codes and descriptions.

Notes

Or. Admin. Code § 410-146-0160

OMAP 2-1999, f. & cert. ef. 2-1-99; OMAP 25-2000, f. 9-28-00, cert. ef. 10-1-00; OMAP 45-2001, f. 9-24-01, cert. ef. 10-1-01; OMAP 59-2002, f. & cert. ef. 10-1-02; DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08; DMAP 42-2017, amend filed 10/03/2017, effective 10/3/2017

Publications: Publications referenced are available from the agency.

Statutory/Other Authority: ORS 413.042 & ORS 414.065

Statutes/Other Implemented: ORS 414.065