Updates for Oregon Health Plan providers
None at this time.
Please continue to refer to the Oregon Medicaid COVID-19 Provider Guide for information related to Oregon Health Plan (OHP) coverage of COVID-19 vaccine, testing, screening, treatment and telemedicine services and other information and resources related to providing and billing for covered services related to COVID-19.
Review what is ending and continuing with the May 2023 end of the COVID-19 Public Health Emergency (PHE): View the May 2023 memo from Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS).
Change Healthcare (CHC) has taken down some of their services to protect patients and partners from a recent cybersecurity incident they are experiencing. If you use CHC you can:
- Use the MMIS Provider Portal at https://www.or-medicaid.gov to bill OHA and verify eligibility. This will be your quickest, easiest option.
- Submit paper claims to OHA.
- Change the clearinghouse you use to bill OHA and verify eligibility. Submit to OHA a new Trading Partner Agreement completed by you and your clearinghouse.
For questions, contact Provider Services at 800-336-6016 (option 5) or DMAP.ProviderServices@oha.oregon.gov.
New fee-for-service Trading Partner Agreement and instructions now available
The updated Oregon Medicaid Trading Partner Agreement (TPA) and new instructions for completing the TPA are now available for fee-for-service providers on OHA's Electronic Data Interchange page.
The previous version of the TPA (OHA 2080) is no longer available. Do not submit this form to OHA for processing after March 31, 2024. Starting April 1, 2024, OHA will only accept TPAs using the updated form below.
Coordinated care organizations (CCOs) should contact their Encounter Data Liaison for the new Trading Partner Agreement designed for CCOs.
For questions regarding the TPA, please email OHA.TPAgreements@odhsoha.oregon.gov.
 Provider resource updates
Climate support member fact sheets, provider FAQ, climate support request form and more on the new Climate Supports page (3/1/2024)
School-Based Health Services Information Session Slides, Recording and Referring Provider Enrollment Instructions (3/1/2024)
Health-Related Social Needs Climate Device Fee Schedule (3/1/2024)
Medical Necessity/Appropriateness Review: Frequently Asked Questions for Secure Residential Treatment Facilities (3/4/2024)
Approved culturally and linguistically specific services providers (3/4/2024)
March 2024 Behavioral Health Fee Schedule (3/8/2024) - This includes the 3.4% rate increase for services effective Oct. 1, 2023. OHA updated MMIS with these rates March 1, 2024.
Recent rule revisions
Reminders
Only send confidential claims as follows:
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