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Procedure code 99483 for cognitive assessment and care plan services has been opened to fee-for-serivce (FFS) providers. CCOs already reimburse their providers for this code, but it has not been open to FFS providers. This misalignment has resulted in uneven coverage of this service for OHP members.
Retroactively effective to January 1, 2024, OHA has opened this code to FFS providers. OHA’s FFS reimbursement rates use resource-based relative value scale (RBRVS) pricing, which will vary as the Centers for Medicare and Medicaid Services (CMS) updates relative value units (RVUs). Currently, the FFS rates are:
- $168.02 for non-facility
- $117.31 for facility
OHA will communicate these rates to FFS providers in the very near future and add them to the FFS fee schedule by the end of March.
What should you do?
CCOs should evaluate the operational impact of the FFS rates on activities such as claim processing and provider contracting and make any necessary updates.
Questions?
- If you have general questions about this communication, please contact Cheryl Henning, CCO Contracts Administrator, at Cheryl.L.Henning@oha.oregon.gov.
- If you have questions about this procedure code, please contact Jason Daniels, Medicaid Medical/Surgical Policy Analyst, at Jason.H.Daniels@oha.oregon.gov.
The 2024 revision of Centering Health and Well-Being in Education resource is now available. The purpose of this document is to help schools and districts identify partnerships and funding opportunities that develop and sustain health and wellness initiatives in support of student physical, mental, and behavioral health as well as overall well-being, thus leading to academic improvements.
Many of the examples in the resource guide describe partnerships between school districts, Licensed Practitioners of the Healing Arts, healthcare, and/or Community-based organizations (CBOs).
As a result of OAR 309-019-0226(4) the ACT Universal Referral Form is now a requirement. Please share this with your SPOC and in any community education opportunities.
Civil commitment rule changes are now in an extended public comment period, through March 20, 2024. Proposed Oregon Administrative Rule (OAR) changes affect:
309-033-0210, 309-033-0220, 309-033-0230, 309-033-0240, 309-033-0250, 309-033-0260, 309-033-0265, 309-033-0270, 309-033-0280, 309-033-0282, 309-033-0290, 309-033-0300, 309-033-0310, 309-033-0320, 309-033-0530, 309-033-0550, 309-033-0725, 309-033-0733, 309-033-0800, 309-033-0820, 309-033-0900, 309-033-0920,309-033-0930, 309-033-0940, 309-033-0950, 309-033-0960
Please review the Notice of Proposed Rule Making and send an email to zachary.l.thornhill@oha.oregon.gov with any suggestions, feedback, concerns, or other notes.
Learn more about Oregon Health Plan Rulemaking.
Helpful resources
- The daily legislative schedule will be posted on the 2024 OLIS page.
- You can find agendas and recordings for the following committees:
- OHA legislative reports will be posted to the Government Relations page.
- 1 to 2:30 p.m., February 22, 2024
- 10:30 a.m. to 12 p.m., March 6, 2024
- 1 to 2:30 p.m., March 14, 2024
- 10:30 to 11:30 a.m., March 19, 2024
Learn more about these RACs and the rulemaking process.
State offices are closed on Monday, February 19 in observance of President's Day.
February 20, 2024
February 21, 2024
Please visit the committee and workgroup links below for more information about meetings. You can also view the OHA Public Meeting calendar.
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