1. (1) Each ground ambulance service organization that has established local rates for ground ambulance services provided in their geographic area must submit the established local rates in an electronic format prescribed by the director of the Department of Consumer and Business Services and in accordance with instructions set forth on the website of the Division of Financial Regulation of the Department of Consumer and Business Services at dfr.oregon.gov. Established local rates for ground ambulance services include rates for services provided directly by the local government entity and contracted rates.
2. (2) Established local rates are reported to the department by ground ambulance service organizations for transparency purposes. For billing purposes, the health benefit plan and ground ambulance services organization will determine the payment amount based on the allowed amount at the time and place of the service pursuant to sections (1) and (2) of OAR 836-053-0454.

3. (3) Ground ambulance service organizations must include the following rate information in their submission to the department for each established local rate or contracted rate submitted to the department:

   1. (a) The ground ambulance service organization’s full legal name and address;
   2. (b) The national provider identifier(s) (NPI) for any ground ambulance services organization to which the rate applies;
   3. (c) The effective date of the rate and any known expiration date of the rate;
   4. (d) The service area of the ground ambulance service organization, described by listing the geographic zone improvement plan (ZIP) codes established by the United States Postal Service that are included in the entity's service area;
   5. (e) The applicable transport codes to which the rate applies, including any separate mileage code or codes;
   6. (f) If applicable, the established local rate for services provided to nonresidents of the local government entity's service area, if a distinction is made in rates between services provided to residents and those provided to nonresidents.

4. (4) Ground ambulance service organizations must submit their established local rates to the department on the following schedule:

   1. (a) Rates must be submitted on or before January 1, 2026 and thereafter, annually on or before October 1.
   2. (b) Updated rates must be submitted within five calendar days of a change to the rates.
5. (5) For purposes of this rule "contracted rates" means rates established in a contract or contracts between a local government entity and a private ground ambulance services organization to provide ground ambulance services in their geographic service area.

Statutory/Other Authority

ORS 743B.292

Statutes/Other Implemented

ORS 743B.292

History

ID 7-2026, adopt filed 06/24/2026, effective 06/29/2026
ID 15-2025, temporary adopt filed 12/17/2025, effective 01/01/2026 through 06/29/2026