Medical-Surgical Services program
Oregon Administrative Rules
Chapter 410 Division 130 - Currently on file with Oregon Secretary of State
Recent rule revisions
- 04/04/2014 (P) - Elimination of Oregon Health Plan Standard Benefit Plan Effective January 1, 2014
- 03/13/2014 (P) - 410-130-0255 - Immunization, Vaccines for Children and Immune Globulins Rule Rewritten Clarifying Language and Removing Table
- 01/01/2014 (T) - 410-130-0240, 410-130-00163 - Elimination of OHP Standard benefit plan effective January 1, 2014
- 01/01/2014 (P) - 410-130-0015 - Payment process for doula services provided at the time of labor and delivery
- 09/25/2013 (P) - 410-130-0005, 410-1300-0255 and 410-120-1340 – Increase payment for certain primary care practitioners and increase the VFC administration fee.
- 06/25/2013 (P) – 410-130-0180 and 410-130-0240 – Align with other rules referenced; establish clarity, and change in coding for pharmacy clozaril monitoring
- 03/29/2013 (T) - 410-130-0255 and 410-130-0005 - Increase payment for certain primary care practitioners and increase the VFC administration fee
Medical-Surgical Provider Guide - Updated 9/1/12. Includes information about where to find codes; prior authorization; pharmaceutical references; primary case management services; blood lead screening and risk assessment; hysterectomy and sterilization consent; maternity case management forms; fluoride charts.
National Drug Code (NDC) Billing Tips - 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).
EDMS Coversheet (pdf) - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or hysterectomy/sterilization consent forms to DMAP.
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.
Who to call for help