Are you ready for ICD-10?

Learn the steps to ICD-10 readiness

Visit DMAP's ICD-10 page for more information

Coding resources

Hospital Acquired Condition Categories and Codes

Other Provider Preventable Condition Diagnosis Codes

Diagnosis Codes Exempt from 30-Day Readmissions Policy

Revenue Center Code List

Unit of measure list for NDC reporting

See also:

Billing tips - How to submit claims to DMAP

Prior authorization (PA) handbook

How to submit PA requests on the Web

Ancillary Services Criteria

Tools for providers

Hospital Tax Rules and Forms

 

Hospital services program

Receive Hospital Services program updates by e-mail

Oregon Administrative Rules

Chapter 410 Division 125 - Currently on file with Oregon Secretary of State

Recent rule revisions

Administrative rulebooks

04/04/2014 - 01/01/2014 - 08/29/2013 - 07/01/2012 - 01/01/2012

07/01/2011 - 01/01/2011 - 07/01/2010

Zip files of rulebooks for 2007-2009 - 2003-2006

Supplemental information

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).

Hospital Presumptive Eligibility - Forms, resources and other information

Ambulatory Payment Classification (APC) resources

Fact sheet - Claim reprocessing to apply APC methodology

Oregon MMIS APC fact sheet

APC indicators and pricing actions

Wage index for hospitals subject to APC methodology - 2012 - 2013 - 2014

APC Codes - 2012 and 2013

Standard Population Limited Hospital Benefit Code Lists

Effective Jan. 1, 2012, OHP Standard hospital benefits are the same as OHP Plus hospital benefits.

July 1, 2008 Sept. 1, 2004 Aug. 1, 2004

Forms

EDMS Coversheet - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or claims to DMAP.

Prior Authorization Request Form - Use this form to submit faxed PA requests to DMAP. Click here for instructions.

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.

Inpatient Hospital Hold Request for OHP Application - Submit this form once daily via secure email to application.requests@state.or.us.

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

Medicare weights - Version 31, effective Oct. 1, 2013; Version 30, effective Oct. 1, 2012; Version 29, effective Oct. 1, 2011; Version 28, effective Oct. 1, 2010; Version 27, effective Oct. 1, 2009 - Older DRG Weights (zip file)

Oregon unique weights - Effective Oct. 1, 2007

Rate tables

Find the clinical lab fee schedule in DMAP's fee-for-service fee schedule.

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.

Interim rates for Type A and B hospitals Pass-through rates for DRG hospitals
July 1, 2014 July 1, 2014
June 1, 2014 June 1, 2014
May 1, 2014 May 1, 2014
April 1, 2014 April 1, 2014
March 1, 2014 March 1, 2014
February 1, 2014 February 1, 2014
January 1, 2014 January 1, 2014
December 1, 2013 December 1, 2013
November 1, 2013 November 1, 2013
October 1, 2013 October 1, 2013
September 1, 2013 September 1, 2013
August 1, 2013 August 1, 2013
July 1, 2013 July 1, 2013
June 1, 2013 June 1, 2013
May 1, 2013 May 1, 2013
April 1, 2013 April 1, 2013
March 1, 2013 March 1, 2013
February 1, 2013 February 1, 2013
January 1, 2013 January 1, 2013

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Who to call for help

Provider Services 800-336-6016 or e-mail us
Address and telephone contacts (pdf)