DMAP administrative rules and supplemental information for:
Hospital services program
Receive
Hospital Services program updates by e-mail
Rulebook
January 1, 2012 (pdf) (Current administrative rules; see below for archived rules)
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Supplemental information
Hospital Services Supplemental Information (pdf) - Updated 8/2/11 - Includes Revenue Center Code Table, prior authorization (PA) information, billing information, forms, and Electronic Data Interchange (EDI) information.
Hospital Acquired Condition Categories and Codes (pdf) - Updated 4/14/11
Hysterectomy and Sterilization Procedures Manual (pdf) - Updated 2/1/08 - For all providers who bill for hysterectomies and sterilizations; provides information and tips not found in the administrative rules.
National Drug Code (NDC) Billing Tips (pdf) - This document explains how to enter NDC information on medical and institutional outpatient claims for codes that require NDC reporting (e.g., physician-administered drugs). Also see DMAP's frequently asked questions about NDC requirements (link).
Standard Population Limited Hospital Benefit Code Lists
Effective Jan. 1, 2012, OHP Standard hospital benefits are the same as OHP Plus hospital benefits.
July 1, 2008 
Sept.
1, 2004 Aug.
1, 2004
Forms
EDMS Coversheet (pdf) - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or claims to DMAP.
DHS Prior Authorization Request Form - Use this form to submit faxed PA requests to DMAP. Click here for instructions. You can also submit the same information using the Provider Web Portal. Read the handbook or view the tutorial for more information about submitting PA requests on the Web.
Oregon Pharmacy and Oral Nutritional Supplement PA Request (pdf) - When requesting prior authorization for drugs or oral nutritional supplements dispensed to OHP clients on a fee-for-service basis, fax this form to the Oregon Pharmacy Call Center at 888-346-0178.
Inpatient Hospital Hold Request for OHP Application (pdf)
Newborn Notification Form (pdf) - To receive prompt payment for delivery services covered by DMAP, notify the OHA Statewide Medical Processing Center when you deliver newborns for OHP clients.
Diagnostic Related Group (DRG) Weights (pdf)
Medicare weights - Version 29, effective Oct. 1, 2011; Version 28, effective Oct. 1, 2010; Version 27, effective Oct. 1, 2009
Oregon unique weights - Effective Oct. 1, 2007
Rate tables (pdf)
Child and Adolescent Psychiatric Services Rates by Contracted Hospital - New! Effective 8/1/08
DMAP only posts the following rates for the current and previous year. For earlier rates, contact DMAP.
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Who to call for help
Provider Services 800-336-6016 or e-mail us
Address
and telephone contacts (pdf)