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Medical-Surgical Services Program


Oregon Administrative Rules and supplemental information administered by the Health Systems Division.

 Receive program updates by text or email - Please specify which program(s) you are interested in; otherwise, you will receive updates for all programs.

Current Oregon Administrative Rules

Please refer to the Oregon Secretary of State website. OHA no longer maintains the administrative rulebooks.

  • Click the program name, then click the rule you want to view.
  • The current rule will display. To view previous revisions of the rule, click the revision date(s) at the bottom of the rule page. Revisions are available back to 2017.
  • If you need older revisions, please email
  • If you have problems accessing older revisions not available on the SOS website, please email

Recent Rule Filings

Supplemental Information and Guidelines

Oregon Medicaid PA Criteria

The Oregon Pharmacy Call Center uses these criteria when reviewing prior authorization (PA) requests for fee-for-service prescriptions.

Preferred Drug List

Physical health drugs on this list do not require PA. Lists before 2012 are in Oregon Administrative Rule 410-121-0030 (Tables 410-121-0030-1 and 410-121-0030-2). You can also use the Searchable PDL.



Policy Quick Links

Rules and Guidelines by Program

Temporary Rule Filings

Permanent Rule Filings

Notices of Proposed Rulemaking

Medical-Surgical Quick Links

Prioritized List of Health Services

Medicare Physician Fee Schedule

NDC reporting for physician-administered drugs

Code Groups

Group 1118 - Excluded Procedure Codes (referenced in OAR 410-130-0220)

Group 1119 - Diagnostic Procedure Codes

Group 6030 - Undefined Diagnosis Codes

Group 6031 - Conditions Not Covered

Group 6032- Diagnostic Workup File

Group 6033 - Informational Diagnosis Codes

Group 6060 - Ancillary Services

Community Births

Reimbursement Guide 


Vaccines for Children Program

State Supplied Vaccine Codes - To bill for the $21.96 administration fee, you must use modifier SL with the vaccine-specific CPT code.

Who to Call for Help

Provider Services

For services to patients not enrolled in a coordinated care organization for physical health care:

 800-336-6016 or  email us

 Address and telephone contacts