Tools for Oregon Health Plan providers

Search All Provider Tools

Use the Search field to find the tool you need. For example, enter "guide" to view all provider guides, "claim" or "billing" to view tools related to claims or billing, or "APC" to view all ambulatory payment classification (APC) tools.

• To view current rules, please visit the OHP policies page.
• To view the fee schedule, please visit the OHP fee schedule page.
• To find Medicaid Program Integrity resources, please visit the CMS website.

Need help? If you can't find what you need on this page or in the "Important Links," see our provider contacts list, and the list at the bottom of this page. If you need help with approval or payment for services to a CCO member, contact the CCO.

Recent Provider Updates

Read the latest Provider Matters

View past issues on the Provider Matters page.

Issue Date    Link    6/2/2023 Reminder: Citizenship Waived Medical (CWM) members remain eligible for COVID-19 testing, vaccines and treatment.    Citizenship Waived Medical (CWM) members remain eligible for COVID-19 testing, vaccines and treatment; Sign up for Keep Covered campaign overview; PHE Authorities and Flexibilities Memo; Oregon Resource Allocation Advisory Committee now seeking feedback about Oregon's crisis care guidelines; OHA seeks public comment on health care transaction; Learn more about upcoming changes to OHP and other Medicaid benefits; June Provider Webinar featuring the Fair Housing Council of Oregon; Join OHA's new quarterly collaborative for physical and occupational therapy providers; Air conditioner and air filter device distribution for 2023; Provider resource updates

Compliance Details

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Read recent OHP announcements

To view older announcements, visit our Announcements page:

Issue Date       Announcement (PDF)    Applies To    5/31/2023 PHE Authorities and Flexibilities Memo All Providers, CCOs 5/24/2023 Certified Recovery Mentors and Oregon Medicaid provider enrollment requirements Behavioral health providers, Prospective Certified Recovery Mentors 5/16/2023 Providers should bill Oregon Health Authority for abortion services and CCOs for miscarriage management CCOs, Reproductive health providers

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Compliance Details

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Forms and Publications

View OHP Billing Tips or the provider guidelines for your program for more information about provider forms. Find forms for enrolling as an OHP provider on our Provider Enrollment page.

• Click the "Form and Description" heading to sort or select by Form. You can also sort or select by Language.
• To view all OHP forms and publications, visit our Forms page.

Form Number Form and Description Language Advance Directive Advance Directive English MSC 0189 MSC 0189 - Direct Deposit Authorization English MSC 1419 MSC 1419 - MAC Local Match Leveraging Form English

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Compliance Details

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Questions and Answers for OHP providers

Use the Search field to filter the questions for your search term.

• If you have questions about how to authorize or bill for services to OHP health plan members, contact the member's OHP coordinated care organization or dental plan.
• If you have questions about services to members not in an OHP health plan, see our address and phone contacts.

Find OHP Provider Contacts by Topic