Hospital services program
Oregon Administrative Rules
Chapter 410 Division 125 - Currently on file with Oregon Secretary of State
Recent rule revisions
July 1, 2012 - 410-125-0120, 410-125-0145, 410-125-0150, 410-125-0155, 410-125-0195, 410-125-0410 and 410-125-0450 Revisions to methodology, perm temporary rules, add clarifying language and repeal a rule.
Hospital Services Provider Guide - Updated 9/1/12
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).
Ambulatory Payment Classification (APC) resources
Standard Population Limited Hospital Benefit Code Lists
Effective Jan. 1, 2012, OHP Standard hospital benefits are the same as OHP Plus hospital benefits.
EDMS Coversheet - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or claims to DMAP.
Oregon Pharmacy and Oral Nutritional Supplement PA Request - 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.
Newborn Notification Form - 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
Oregon unique weights - Effective Oct. 1, 2007
Child and Adolescent Psychiatric Services Rates by Contracted Hospital -Effective 8/1/08
DMAP only posts the following rates for the current and previous year. For earlier rates, contact DMAP.
Who to call for help