Oregon Administrative Rules|Section 410-133-0300 - Procedure Codes

                                                
Current through Register Vol. 60, No. 12, December 1, 2021 
(1) The provider must use the procedure code from the School-Based Health Services table that best describes the specific service provided and a modifier that describes the discipline providing the service. Refer to 410-133-0080 Coverage for service requirements and limitations.
 
(2) Unit values equal 15 minutes of service unless otherwise stated. These time units must be documented in the Medicaid-eligible student's records under the services billed and accounted for under one code only.
 
(3) Visit. A service measurement of time for billing and reimbursement efficiency. One visit equals the school provider's hourly cost rate for category of service provided (i.e., occupational therapy, physical therapy, speech therapy, etc.) specified in an IEP or IFSP, divided by 60 to yield a cost per minute; per minute cost is then multiplied by amount of service time provided in minutes. For billing purposes, a visit is always presented as one visit.
 
Or. Admin. R. 410-133-0300
HR 39-1991, f. & cert. ef. 9-16-91; HR 29-1993, f. & cert. ef. 10-1-93; HR21-1995, f. & cert. ef. 12-1-95; OMAP 1-1998, f. 1-30-98, cert. ef. 2-1-98; OMAP 38-1999, f. & cert. ef. 10-1-99; OMAP 15-2000, f. 9-28-00, cert. ef 10-1-00; OMAP 31-2003, f. & cert. ef. 4-1-03; OMAP 53-2003, f. 8-13-03 cert. ef. 9-1-03; OMAP 24-2005(Temp), f. & cert. ef. 4-5-05 thru 10-1-05; OMAP 53-2005, f. 9-30-05, cert. ef. 10-1-05; DMAP 33-2016, f. 6-29-16, cert. ef. 7-1-16
Stat. Auth.: ORS 413.042 & 414.065
 
Stats. Implemented: ORS 413.042 & 414.065
This section was updated on 8/29/2016 by overlay.