1. (1) When an examination is needed, administrative examination codes are authorized by the branch office.
2. (2) Medical and ancillary services providers must bill using the Provider Web Portal at https://www.or-medicaid.gov or on a CMS-1500, mailed to the address listed on the OHP 729 at https://www.oregon.gov/oha/HSD/OHP/Pages/Policy-Admin-Exam.aspx.
3. (3) Hospital services must be billed on a UB-04.
4. (4) Record copying fees imposed by a copy service provider must be billed on a CMS – 1500.

5. (5) For Administrative Examination billing, the following are required on the appropriate billing form:

   1. (a) The procedure codes specified on the OHP 729;
   2. (b) The diagnosis code Z02.89.

Statutory/Other Authority

ORS 413.042

Statutes/Other Implemented

ORS 414.065

History

DMAP 41-2019, adopt filed 10/01/2019, effective 12/01/2019