OHP fee schedule for fee-for-service providers

Quarterly updates of the maximum allowable payment rates that apply to services directly billed to DMAP, in compliance with applicable law.

 

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Fee schedule (for general information only - last updated March 2013)

The fee schedules reflect information available in the month posted, and do not reflect fees for all programs. Rates may change without notice. Only codes with rate changes in the month posted will show a new effective date.

NOTE: New federal primary care rates are not included in the March 2013 fee schedule. They will be included in the April/May 2013 fee schedule, after federal CMS approval is received.

• Download the fee schedule in comma delimited text (CSV) or PDF or Excel format. A description of recent changes is available.
   
• Older versions of the fee schedule are available online.

Other resources

To learn more about the fee schedule format, read our file specifications. Also learn about DMAP's maximum allowable rates for the main types of services listed in the fee schedule.

• Oregon's primary care rate - eligible provider types and procedure codes - Note: The Oregon primary care rate is different from the federal primary care rate increase for 2013-14.
• Federal primary care rate increase (2013-2014) information
• For program-specific rates not listed in the OHP fee schedule and any program-specific payment policies that may apply: Refer to your provider guidelines, rules or contracts.
• For billing, service coverage, accepted codes and DMAP payment policies: See the OHP Billing Tips, DMAP General Rules, and OHP Administrative Rules.
• For prior authorization, procedure-specific coverage for an OHP client or benefit plan, or Prioritized List of Health Services coverage: Use the Benefits and HSC List Inquiry search on the secure Provider Web Portal.

Need help?

• For rates and covered procedures for chemical dependency and mental health services, go to AMH Tools for Providers.
• For reimbursement rates for services to OHP health plan members, contact the OHP health plan.
• For questions about the rates listed on the fee schedule, contact DMAP Provider Services.