OAR 410-172-0840
Personal Care Attendant Payment Limitations

(1)

The number of behavioral health personal care attendant service hours authorized for an individual per calendar month is based on projected amounts of time to perform specific personal care and supportive services to the eligible individual. The total of these hours are limited to 20 hours per individual per month. Individuals whose assessed service needs exceed the 20 hour limit may receive approval for additional hours.

(2)

The Authority shall pay for behavioral health personal care attendant services when all acceptable provider enrollment standards have been verified and both the employer and provider have been formally notified in writing that payment by the Authority is authorized.

(3)

In accordance with OAR 410-120-1300 (Timely Submission of Claims), all provider claims for payment shall be submitted within 12 months of the date of service.

(4)

Payment may not be claimed by a provider until the hours authorized for the payment period have been completed, as directed by an eligible individual or the individual’s representative.

Source: Rule 410-172-0840 — Personal Care Attendant Payment Limitations, https://secure.­sos.­state.­or.­us/oard/view.­action?ruleNumber=410-172-0840.

410‑172‑0600
Acronyms and Definitions 410‑172‑0610
Provider Enrollment 410‑172‑0620
Documentation Standards 410‑172‑0630
Medically Appropriate 410‑172‑0640
Behavioral Health Services Fee Schedule 410‑172‑0650
Prior Authorization 410‑172‑0660
Rehabilitative Behavioral Health Services 410‑172‑0670
Substance Use Disorder Treatment Services 410‑172‑0680
Residential Treatment Services for Children 410‑172‑0690
Admission Procedure for Residential Treatment Services for Children 410‑172‑0695
Intensive In-Home Behavioral Health Treatment Services for Youth (IIHBT) 410‑172‑0705
Residential Rate Standardization 410‑172‑0710
Residential Personal Care 410‑172‑0720
Prior Authorization and Re-Authorization for Residential Treatment 410‑172‑0730
Payment Limitations for Behavioral Health Services 410‑172‑0745
Exception Criteria for Facial Gender Confirmation Surgery (FGCS) 410‑172‑0760
Applied Behavior Analysis 410‑172‑0770
Individual Eligibility for Applied Behavioral Analysis Treatment 410‑172‑0780
Behavioral Health Personal Care Attendant Program 410‑172‑0790
Eligibility for Behavioral Health Personal Care Attendant Services 410‑172‑0800
Personal Care Attendant Employer-Employee Relationship 410‑172‑0810
Personal Care Attendant Qualifications 410‑172‑0820
Provider Termination 410‑172‑0830
Personal Care Attendant Service Assessment, Authorization, and Monitoring 410‑172‑0840
Personal Care Attendant Payment Limitations 410‑172‑0850
Telemedicine for Behavioral Health 410‑172‑0860
Billing for Dual Eligible Individuals
Last Updated

Jun. 8, 2021

Rule 410-172-0840’s source at or​.us