As we work together to stop the spread of COVID-19 at home, work and in the community, we want to make sure you have the resources you need to keep informed, healthy and safe. If you have any questions about OHP and COVID-19, please let us know.
Updates for Oregon Health Plan providers
Add-on fee for interpreter services now open for fee-for-service payment: From Jan. 1, 2021, through June 30, 2021, the Oregon Health Authority (OHA) will pay an administrative add-on fee for interpreter services at Oregon Health Plan (OHP)-covered health care visits (including telehealth visits). The fee is payable at a rate of $60 once per event.
Reminder about temporary expansion of CAWEM-only (CWM) coverage for COVID-19-related services: During the COVID-19 emergency, the CAWEM benefit includes all services for the diagnosis and treatment of COVID-19. COVID-19 vaccine administration is also covered when the diagnosis code Z23 (Encounter for immunization) is used for billing.
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This coverage is not limited to emergency rooms and hospitals. OHA can reimburse providers for COVID-19-related services regardless of service location. Coverage includes non-emergency settings such as medical offices, urgent care and pharmacies.
- Providers can bill OHA for COVID-19-related services provided on or after Feb. 1, 2020.
If you have questions or encounter any billing challenges, please contact OHP Provider Services (800-336-6016).
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to OHP coverage of testing, screening, treatment and telemedicine services; OHP eligibility; and other information and resources related to providing and billing for covered services during COVID-19.
- The guide now contains billing guidance for COVID-19 vaccine administration, monoclonal antibody administration, and the new add-on fee for the cost of interpreter services at covered health care visits. The Eligibility section has been updated to note that COVID-19 vaccine administration is also covered for CAWEM-eligible members.
Supporting dental visits for children during COVID-19 and beyond
The current public health emergency creates special challenges for parents to bring their children in for preventive dental visits. OHA is sharing some resources to help make that a little easier.
Dental providers can share with parents these handouts from the National Maternal and Child Oral Resource Center. They are also posted under the "Dental Providers" tab on OHA’s COVID-19 Healthcare Partner Resources web page.
OHA also has a toolkit of communications materials for CCOs to use for promoting well-child (including childhood immunizations) and preventive dental visits. Our goal has been to create a set of tools that all CCOs can easily use to reach out to members and encourage them to make these important appointments for their children. The materials include a brochure, social media assets, advertising assets and more. All materials are available in English and Spanish.
Updates for all health care providers
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Prioritized List update: Change log for Jan. 1, 2021 list
On Dec. 31, 2020, the Health Evidence Review Commission published a change log to the 1/1/2021 Prioritized List of Health Services to include the following changes:
- Remove obsolete procedure codes C9745, G0297 and G2058 from all lines of the list
Questions? Please email HERC.Info@dhsoha.state.or.us.
Recent rule revisions
Save the date: 2021 Visual Services collaboratives
To promote understanding of OHP's fee-for-service Visual Services policies and coverage, OHA will start holding quarterly virtual collaboratives in 2021.
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Day and time: Tuesdays, 10 to 11:30 a.m.
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Dates: March 9, June 8, Sep. 7 and Dec. 7, 2021
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Location: Virtual meeting, platform to be determined
Coordinated care organizations, providers, and any other health care partners interested in ensuring appropriate access to visual services are encouraged to attend.
If you are interested in joining, please express your interest via email to both napuaann.k.rich@dhsoha.state.or.us and shannon.d.jasper@dhsoha.state.or.us.
Reminder: OHP policy page updates
The OHP policy web pages have been updated as follows, effective Jan. 1, 2021. Please update your favorites or bookmarks accordingly.
Other features on the policy web pages are not changing. You will still be able access recent rule filing information, guides, forms, fee schedules, previous versions of the Covered and Non-Covered Dental Services list, and other documents as you do today.
Questions?
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