1. (1) The Division uses HIPAA compliant modifiers for many services.

2. (2) The following services require the use of a modifier for all services for all procedures:

   1. (a) Family planning service -- FP, refer to OAR 410-130-0585 Family Planning Services;
   2. (b) Vaccine for children -- SL or 26, refer to OAR 410-130-0255.
3. (3) When billing for services that are reimbursed outside an IHCP’s cost-based or IHS rate, a clinic must use the required modifier listed in the individual program-specific administrative rules.

Statutory/Other Authority

ORS 413.042 & ORS 414.065

Statutes/Other Implemented

ORS 414.065

History

DMAP 42-2017, amend filed 10/03/2017, effective 10/03/2017
DMAP 34-2008, f. 11-26-08, cert. ef. 12-1-08
DMAP 19-2007, f. 12-5-07, cert. ef. 1-1-08
OMAP 68-2003, f. 9-12-03, cert. ef. 10-1-03
OMAP 59-2002, f. & cert. ef. 10-1-02