OAR 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.

Source: Rule 410-146-0160 — Administrative Medical Examinations and Reports, https://secure.sos.state.or.us/oard/view.action?ruleNumber=410-146-0160.

410–146–0000
Foreword 410–146–0020
Memorandum of Agreement Reimbursement Methodology 410–146–0021
American Indian/Alaska Native (AI/AN) Provider Enrollment 410–146–0040
ICD-10-CM Diagnosis Codes and CPT/HCPCs Procedure Codes 410–146–0060
Prior Authorization 410–146–0075
Client Copayments 410–146–0080
Professional Ambulatory Services 410–146–0085
Encounter and Recognized Practitioners 410–146–0086
Multiple Encounters 410–146–0100
Vaccines for Children 410–146–0120
Maternity Case Management Services 410–146–0130
Modifiers 410–146–0160
Administrative Medical Examinations and Reports 410–146–0200
Pharmacy 410–146–0220
Death With Dignity 410–146–0240
Transportation 410–146–0440
Prepaid Health Plan Supplemental Payments 410–146–0460
Compensation for Outstationed Eligibility Workers

Last Updated

Jun. 8, 2021

Rule 410-146-0160’s source at or.us

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Location: https://oregon.public.law/rules/oar_410-146-0160

Original Source: Rule 410-146-0160 — Administrative Medical Examinations and Reports, https://secure.sos.state.or.us/oard/view.action?ruleNumber=410-146-0160 (last accessed Jun. 8, 2021).

OAR 410-146-0160 Administrative Medical Examinations and Reports

OAR 410-146-0160
Administrative Medical Examinations and Reports