DMAP administrative rules and other information for:
Medical-Surgical services program
Receive
Medical-Surgical services program updates by e-mail
Rulebook
January 1, 2012 (pdf) (Current administrative rules. See below for archived rules.)
You need the free Adobe Reader to view these documents. If you do not already have Adobe Reader 6.0 or higher on your computer, you can download it now.
Supplemental information
Medical-Surgical Supplemental Information (pdf) - Updated 9/27/11 - Includes information about where to find codes; prior authorization; pharmaceutical references; primary case management services; blood lead screening and risk assessment; hysterectomy and sterilization consent; billing instructions and forms; maternity case management forms; fluoride charts.
Hysterectomy and Sterilization Procedures Manual (pdf) - For all providers who bill for hysterectomies and sterilizations; provides information and tips not found in the administrative rules.
National Drug Code (NDC) Billing Tips (pdf) - This document explains how to enter NDC information on medical and institutional claims for physician-administered drugs). Also see DMAP's frequently asked questions about NDC requirements (link).
Forms
EDMS Coversheet (pdf) - Use this form whenever you fax documentation for prior authorization requests, provider enrollment requests, or hysterectomy/sterilization consent forms to DMAP.
DHS Prior Authorization Request Form - Use this form to submit faxed PA requests to DMAP. Click here for instructions. You can also submit the same information using the Provider Web Portal. Read the handbook or view the tutorial for more information about submitting PA requests on the Web.
Oregon Pharmacy and Oral Nutritional Supplement PA Request (pdf) - 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.
Hysterectomy Consent Form - English or Spanish
Consent to Sterilization Form (age 21 or over) - English or Spanish
Consent to Sterilization Form (ages 15 through 20) - English or Spanish
Maternity Case Management Forms - Initial Assessment, Training and Education Tracking, Home and Environmental Assessment, FAIR for Smoking Cessation
Lead Risk Assessment Questionnaire
Who to call for help
Provider Services 800-336-6016 or e-mail us
Address
and telephone contacts