OAR 436-120-0720
Fee Schedule

(1)

The director has established the fee schedule in section (3) of this rule for professional costs and direct worker purchases. The schedule sets maximum spending limits per claim opening for each category; however, the insurer may spend more than the maximum limit. Spending limits will be adjusted annually, effective July 1, based on the conversion factor described in OAR 436-120-0005 (Definitions) and published with the cost-of-living matrix in Bulletin 124.

(2)

For workers needing an extended training plan under OAR 436-120-0443 (Training — General), the fee schedule spending limits for the Training category and Direct Employment/Training Combined category listed below must be increased by 30 percent.

(3)

Amounts include professional costs, travel and wait time, and other travel expenses: [Table not included. See ED. NOTE.]
NOTE: *Each limit is shown as a percentage of Oregon’s state average weekly wage (SAWW), determined under ORS 656.211 (“Average weekly wage” defined). Dollar amounts are published in Bulletin 124 and are adjusted annually, effective July 1, based on changes in the SAWW.

(4)

The insurer must pay, within 30 days of receipt, the provider’s bill for services provided under the insurer-provider agreement. The insurer may not deny payment on the grounds the worker was not eligible for the assistance if the provider performed the services in good faith without knowledge of the ineligibility.
[ED. NOTE: Tables referenced are available from the agency.]
[ED. NOTE: To view attachments referenced in rule text, click here to view rule.]

Source: Rule 436-120-0720 — Fee Schedule, .

436‑120‑0003
General Provisions 436‑120‑0005
Definitions 436‑120‑0008
Administrative Review and Hearings 436‑120‑0012
General Requirements For Notices and Warnings 436‑120‑0115
Vocational Eligibility Evaluation 436‑120‑0117
Deferral of Eligibility Evaluation 436‑120‑0145
Vocational Assistance Eligibility 436‑120‑0147
Establishing the Adjusted Weekly Wage 436‑120‑0157
Determining Substantial Handicap to Employment 436‑120‑0165
End of Eligibility for Vocational Assistance 436‑120‑0175
Redetermining Eligibility for Vocational Assistance 436‑120‑0177
Selection of Category of Vocational Assistance 436‑120‑0185
Choosing a Counselor 436‑120‑0187
Optional Services 436‑120‑0197
Direct Employment 436‑120‑0410
Determining a Vocational Goal 436‑120‑0443
Training — General 436‑120‑0445
Training Requirements 436‑120‑0500
Training: Development and Implementation 436‑120‑0510
Training Plan Support 436‑120‑0520
Responsibilities of the Worker and the Counselor 436‑120‑0523
Re-evaluating a Training Plan 436‑120‑0527
Ending a Training Plan 436‑120‑0530
Director Review of Return-to-Work Plan 436‑120‑0700
Direct Worker Purchases 436‑120‑0710
Direct Worker Purchases: Categories 436‑120‑0720
Fee Schedule 436‑120‑0755
Reimbursement from the Workers’ Benefit Fund 436‑120‑0800
Registration of Providers 436‑120‑0810
Certification and Classification of Provider Staff 436‑120‑0820
Renewal of Certification 436‑120‑0840
Professional Standards for Providers and Counselors 436‑120‑0900
Audits, Penalties and Sanctions 436‑120‑0915
Sanctions of Providers and Counselors
Last Updated

Jun. 24, 2021

Rule 436-120-0720’s source at