OAR 410-147-0160
Modifiers


(1)

The Division of Medical Assistance Programs (Division) uses HIPAA compliant modifiers for many services.

(2)

The following conditions require the use of a modifier for all codes:

(a)

Family Planning Service — FP, Refer to OAR 410-130-0585 (Family Planning Services) Family Planning Services

(b)

Vaccine for Children — SL or 26, Refer to OAR 410-130-0255 (Immunizations, Vaccines for Children, and Immune Globulins)(4)

(3)

When billing for services that are reimbursed outside a clinic’s encounter rate, a clinic must use the required modifier(s) listed in the individual program Administrative Rules.

(a)

Enhanced Care Services (including extended care) — HK, Refer to OAR 410-147-0120 (Division Encounter and Recognized Practitioners);

(b)

Assist surgeon for cesarean deliveries for Citizen Alien Waived Emergency Medical (CAWEM) clients — 80, 81, 82 or AS.
Last Updated

Jun. 8, 2021

Rule 410-147-0160’s source at or​.us