Last updated 07/31/2023
Consent Requirements
Prior to the delivery of services via a telemedicine or telehealth modality, a member’s written, oral, or recorded consent to receive services using a telemedicine or telehealth delivery method in a language that the member understands must be obtained by the health system, clinic, or provider and documented in the member’s health record. Consent must include an assessment of member readiness to access and participate in telemedicine or telehealth delivered services, including conveying all other options for receiving the health care service to the member. Consent must be updated at least annually thereafter. For members and their families with LEP or hearing impairments, providers must use qualified or certified health care interpreters, when obtaining patient consent.
SOURCE: OR OAR 410-141-3566, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telehealth Service and Reimbursement. (Accessed Jul. 2023).
Prior to the delivery of services via a telemedicine or telehealth modality, a client or member’s written, oral, or recorded consent to receive services using a telemedicine or telehealth delivery method in the language that the client or member understands must be obtained and documented by the health system, clinic or provider in the client or member’s health record. Consent must include an assessment of client or member readiness to access and participate in telemedicine or telehealth delivered services, including conveying all other options for receiving the health care service to the client or member. Consent must be updated at least annually thereafter. For clients or members who experience LEP or hearing impairment clients , providers must use qualified or certified health care interpreters when obtaining client or member consent.
SOURCE: OR OAR 410-120-1990, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Teledentistry
A patient receiving services through teledentistry shall be notified of the right to receive interactive communication with the distant dentist and shall receive an interactive communication with the distant dentist upon request. This must be reflected in the patient’s chart documentation.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
School Based Health Services
Providers billing Medicaid for SBHS health related services via telehealth must obtain the child’s/student’s parent or guardian’s written or verbal consent to receive the services via telehealth technologies, prior to the delivery of health-related services to an eligible child/student with disabilities using a telehealth modality. Verbal consent must be documented/noted in the child’s plan of care by the practitioner. Consent must be obtained and documented annually or with change in services on the child/students plan of care.
SOURCE: OR OAR 410-133-0080, Health Systems Division: Medical Assistance Programs, School-Based Health Services, Coverage (Accessed Jul. 2023).
Last updated 07/31/2023
Definitions
“Telemedicine” means the mode of delivering health services using information and telecommunication technologies to provide consultation and education or to facilitate diagnosis, treatment, care management or self-management of a patient’s health care.
SOURCE: OR Statute 414.723, (Accessed Jul. 2023).
“Telemedicine” means the mode of delivering remote clinical health services using information and telecommunication technologies to provide consultation and education or to facilitate diagnosis, treatment, care management or self-management of a member’s healthcare.
“Telehealth” includes telemedicine and also includes the use of electronic information and telecommunications technologies to support remote clinical healthcare, member and professional health-related education, public health, and health administration.
“Telecommunication technologies” means the use of devices and services for telemedicine or telehealth delivered services. These technologies include video conferencing, store-and-forward imaging, streaming media including services with information transmitted via landlines, and wireless communications, including the Internet and telephone networks.
SOURCE: OR OAR 410-141-3566, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telehealth Service and Reimbursement & OAR 410-120-1990, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Rules for RHCare Clinics, Certification Requirements for CCare Clinics, Certification Requirements for AbortionCare clinics
“Telehealth” means the provision of healthcare remotely by means of telecommunications technology.
SOURCE: OR Admin Code 333-004-3010, (Accessed Jul. 2023).
Behavioral Health Services
“Telehealth” means a technological solution that provides two-way, video-like communication on a secure line.
SOURCE: OAR 309-032-0860, Health Systems Division: Medical Assistance Programs, Behavioral Health Services. (Accessed Jul. 2023).
Telemedicine encompasses different types of programs, services, and delivery mechanisms for medically appropriate covered services within the recipient’s benefit package.
SOURCE: OR OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health. (Accessed Jul. 2023).
Telehealth services include a variety of health services provided by synchronous or asynchronous electronic communications, including secure electronic health portal, audio, or audio and video and clinician-to-clinician virtual consultations.
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-2. (1/29/23). (Accessed Jul. 2023).
Teledentistry can take multiple forms, both synchronous and asynchronous, including but not limited to:
- Live video, a two-way interaction between a patient and dentist using audiovisual technology;
- Store and forward, an asynchronous transmission of recorded health information such as radiographs, photographs, video, digital impressions, or photomicrographs transmitted through a secure electronic communication system to a dentist, and it is reviewed at a later point in time by a dentist. The dentist at a distant site reviews the information without the patient being present in real time;
- Remote patient monitoring, where personal health and dental information is collected by dental care providers in one location then transmitted electronically to a dentist in a distant site location for use in care; and
- Mobile communication devices such as cell phones, tablet computers, or personal digital assistants may support mobile dentistry, health care, public health practices, and education.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
Telehealth for School Based Health Services (SBHS) is a real time interactive and synchronous audio/video technology from site to site regarding a Medicaid-eligible child’s health-related service. Telehealth is the equivalent to face-to-face therapy/treatment between a licensed practitioner/clinician or under the supervision of a practitioner/clinician within the scope of practice.
SOURCE: OR OAR 410-133-0040, Health Systems Division: Medical Assistance Programs, School-Based Health Services. (Accessed Jul. 2023).
The Behavioral Health Loan Repayment Program and Behavioral Health Care Bonus and Housing Stipend Incentive Program
“Telehealth” means the provision of health services from a distance using electronic communications.
SOURCE: OR Admin Rule 309-081-0010 and 309-083-0010, (Accessed Jul. 2023).
Health Care Provider Incentive Program
“Telehealth” means the provision of health services from a distance using electronic communications.
SOURCE: OR Admin Rule 409-036-0010, (Accessed Jul. 2023).
Aging and People with Disabilities and Developmental Disabilities
“Technology and Telehealth” means electronic or virtual means or methods, including but not limited to computer technology, web or internet access, social media, videoconferencing or other technological means or methods to improve resident social isolation and allow for the provision of virtual health care.
SOURCE: OR OAR 411-062-0010, (Accessed Jul. 2023).
Last updated 07/31/2023
Email, Phone & Fax
“Audio only” means the use of audio technology, permitting real-time communication between a health care provider and a member for the purpose of diagnosis, consultation or treatment. “Audio only” does not include the delivery of health services that are customarily delivered by audio telephone technology and customarily not billed as separate services by a health care provider, such as the sharing of laboratory results.
SOURCE: OAR 410-141-3566. Health Systems Division: Medical Assistance Programs. Oregon Health Plan and 410-120-1990 (Accessed Jul. 2023).
“Audio only” does not include:
- The use of facsimile, electronic mail or text messages.
- The delivery of health services that are customarily delivered by audio telephone technology and customarily not billed as separate services by a health care provider, such as the sharing of laboratory results.
To encourage the efficient use of resources and to promote cost-effective procedures in accordance with ORS 413.011 (1)(L), the Oregon Health Authority shall reimburse the cost of health services delivered using telemedicine, including but not limited to:
- Health services transmitted via landlines, wireless communications, the Internet and telephone networks;
- Synchronous or asynchronous transmissions using audio only, video only, audio and video and transmission of data from remote monitoring devices; and
- Communications between providers or between one or more providers and one or more patients, family members, caregivers or guardians.
The authority shall pay the same reimbursement for a health service regardless of whether the service is provided in person or using any permissible telemedicine application or technology.
SOURCE: OR Revised Statutes Ch. 414.723, (Accessed Jul. 2023).
Covered telephonic and online services include services related to evaluation, assessment and management as well as other technology-based services (CPT 98966-98968, 99441-99443, 99421-99423, 98970-98972, G2012, G2061-G2063, G2251-G2252).
Covered telephone and online services billed using these codes do not include either of the following:
- Services related to a service performed and billed by the physician or qualified health professional within the previous seven days, regardless of whether it is the result of patient-initiated or physician-requested follow-up.
- Services which result in the patient being seen within 24 hours or the next available appointment.
Covered interprofessional consultations include consultations delivered online, through electronic health records or by telephone
(CPT 99446-99449, 99451-99452)..
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-3. (1/29/23). (Accessed Jul. 2023).
“Asynchronous” means not simultaneous or concurrent in time. For the purpose of this rule, asynchronous telecommunication technologies for telemedicine or telehealth services may include audio and video, audio, or member portal and may include transmission of data from remote monitoring. “Asynchronous” does not include voice messages, facsimile, electronic mail or text messages.
SOURCE: OAR 410-141-3566. Health Systems Division: Medical Assistance Programs. Oregon Health Plan and 410-120-1990 (Accessed Jul. 2023).
“Telecommunication technologies” means the use of devices and services for telemedicine or telehealth delivered services. These technologies include video conferencing, store-and-forward imaging, streaming media including services with information transmitted via landlines, and wireless communications, including the Internet and telephone networks.
SOURCE: OR OAR 410-120-1990 & OAR 410-141-3566, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Behavioral Health
Patient consultations using telephone and online or electronic mail (e-mail) are covered when billed services comply with the practice guidelines set forth by the Health Evidence Review Commission and the applicable HERC-approved code requirements, delivered consistent with the HERC Evidence-Based Guidelines; Patient consultations using videoconferencing, a synchronous (live two-way interactive) video transmission resulting in real time communication between a provider located in a distant site and the recipient being evaluated and located in an originating site, is covered when billed services comply with the billing requirements in rule. Behavioral health services specifically identified as allowable for telephonic delivery are listed on the Behavioral Health Fee schedule published by the Authority.
Unless expressly authorized in OAR 410-120-1200 (Exclusions), other types of telecommunications are not covered such as images transmitted via facsimile machines and electronic mail when:
- Those methods are not being used in lieu of videoconferencing, due to limited videoconferencing equipment access; or
- Those methods and specific services are not specifically allowed pursuant to the Oregon Health Evidence Review Commission’s Prioritized List of Health Services and Evidence Based Guidelines.
SOURCE: OR OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health. (Accessed Jul. 2023).
Teledentistry
Mobile communication devices such as cell phones, tablet computers, or personal digital assistants may support mobile dentistry and health care and public health practices and education.
Unless authorized in OAR 410-120-1200 Exclusions or OAR 410-120-1990, other types of telecommunications such as telephone calls, images transmitted via facsimile machines, and electronic mail are not covered:
- When those types are not being used in lieu of teledentistry, due to limited teledentistry equipment access; or
- When those types and specific services are not specifically allowed in this rule per the Oregon Health Evidence Review Commission’s Prioritized List of Health Services.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
School Based Health Services
Telehealth can be interactive audio/telephonic services provided to a child/student in a geographical area where synchronous audio and video is not available or consent for audio/video is refused for services provided to a child/student.
SOURCE: OR OAR 410-133-0040 Health Systems Division: Medical Assistance Programs, School-Based Health Services. (Accessed Jul. 2023).
The Authority may reimburse telehealth, tele-electronic/telephonic School-Based Health Services (SBHS) provided to the same extent the services would be covered if they were provided in person and billed to Medicaid using appropriate SBHS procedure codes and modifiers. See rule for requirements.
For services covered using synchronous audio and video with modifiers GT, the Division will cover the same services provided by synchronous audio (e.g. telephone), when billed with the same codes but without modifier GT when provision of the same service via synchronous audio and video is not available or feasible, when the patient declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in the child/student’s plan of care.
SOURCE: OR OAR 410-133-0080, Health Systems Division: Medical Assistance Programs, School-Based Health Services, Coverage (Accessed Jul. 2023).
Indian Health Services
For the provision of services defined in Titles XIX and XXI and provided through an IHS or Tribal 638 facility, an “encounter” is defined as a face-to-face, telephone contact, or a prescription fill as defined in OAR 410-146-0085(8) between a health care professional and an eligible OHP client within a 24-hour period ending at midnight, as documented in the client’s medical record. Section (7) of this rule outlines limitations for telephone contacts that qualify as encounters. For purposes of this rule, face-to-face “encounter” includes services provided via a synchronous two-way audiovisual link between a patient and a provider per 410-130-0610.
Telephone encounters qualify as a valid encounter for specific services. Telephone encounters must include all the same components of the service when provided face-to-face. Providers may not make telephone contacts at the exclusion of face-to-face visits.
SOURCE: OR OAR 410-146-0085, Health Systems Division: Medical Assistance Programs American Indian/Alaska Native. (Accessed Jul. 2023).
Federally Qualified Health Center and Rural Health Clinics
For the provision of services defined in Titles XIX and XXI and provided through an FQHC or RHC, an “encounter” is defined as a face-to-face or telephone contact between a health care professional and an eligible OHP client within a 24-hour period ending at midnight, as documented in the client’s medical record. See rule for limitations for telephone contacts that qualify as encounters. For purposes of this rule, a face-to-face “encounter” includes services provided via a synchronous two-way audiovisual link between a patient and a provider per OAR 410-130-0610.
Telephone encounters qualify as a valid encounter for services provided in accordance with OAR 410-130-0595, Maternity Case Management (MCM) and 410-130-0190, Tobacco Cessation (see also OAR 410-120-1200). Except as set forth below, providers may not make telephone contacts at the exclusion of face-to-face visits. Telephone encounters must include all the same components of the service as if provided face-to-face.
SOURCE: OR OAR 410-147-0120, Healthy Systems Division: Medical Assistance Programs, Federally Qualified Health Center and Rural Health Clinics Services. (Accessed Jul. 2023).
Last updated 07/31/2023
Live Video
POLICY
To encourage the efficient use of resources and to promote cost-effective procedures in accordance with ORS 413.011 (1)(L), the Oregon Health Authority shall reimburse the cost of health services delivered using telemedicine, including but not limited to:
- Health services transmitted via landlines, wireless communications, the Internet and telephone networks;
- Synchronous or asynchronous transmissions using audio only, video only, audio and video and transmission of data from remote monitoring devices; and
- Communications between providers or between one or more providers and one or more patients, family members, caregivers or guardians.
The authority shall pay the same reimbursement for a health service regardless of whether the service is provided in person or using any permissible telemedicine application or technology.
SOURCE: OR Statute 414.723. (Accessed Jul. 2023).
“Synchronous” means an interaction between a provider and a client or member that occurs at the same time using an interactive technology. This may include audio only, video only, or audio with video and may include remote monitoring.
Communications may be between providers, or be between one or more providers and one or more patients, family members /caregivers /guardians.
SOURCE: OAR 410-141-3566, Health Systems Division: Medical Assistance, Oregon Health Plan, Telehealth Service and Reimbursement Requirements & OAR 410-120-1990 Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Patient consultations using videoconferencing, a synchronous (live two-way interactive) video transmission resulting in real time communication between a provider located in a distant site and the recipient being evaluated and located in an originating site, is covered when billed services comply with the billing requirements. See OAR for billing requirements.
SOURCE: OR OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health. (Accessed Jul. 2023).
Telehealth for School Based Health Services (SBHS) is a real time interactive and synchronous audio/video technology from site to site regarding a Medicaid-eligible child’s health-related service. Telehealth is the equivalent to face-to-face therapy/treatment between a licensed practitioner/clinician or under the supervision of a practitioner/clinician within the scope of practice.
SOURCE: OR OAR 410-133-0040, Health Systems Division: Medical Assistance Programs, School-Based Health Services (Accessed Jul. 2023).
MCEs shall provide reimbursement for telemedicine or telehealth services and reimburse Certified and Qualified Health Care Interpreters (HCIs) as defined in OAR 333-002-0010 for interpretation services provided via telemedicine at the same reimbursement rate as if it were provided in person. This requirement does not supersede the MCEs direct agreement(s) with providers, including but not limited to, alternative payment methodologies, quality and performance measures or Value Based Payment methods described in the MCE contract. However, nothing either in this requirement or within MCE direct agreement(s) with providers referenced herein supersedes any federal or state requirements with regard to the provision and coverage of health care interpreter services.
SOURCE: OAR 410-141-3566. Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telemedicine and Telehealth Delivered Health Service and Reimbursement Requirements. (Accessed Jul. 2023).
The Oregon Health Authority (OHA) will submit a Medicaid State Plan Amendment to the Centers for Medicare & Medicaid Services (CMS) to change from the flat telehealth rates used during the COVID-19 Public Health Emergency (PHE) to rates based on Relative Value Units (RVUs) multiplied by the Oregon conversion factor. See memo for a table that lists the current PHE rate and the proposed RVU-based rate for covered telehealth codes.
SOURCE: Oregon Health Authority, Notice of intent – OHA will amend the Medicaid State Plan to increase rates for telehealth services. Public Notice, May 18, 2023, (accessed 7/28/23).
ELIGIBLE SERVICES/SPECIALTIES
Providers billing for covered telemedicine services are responsible for the following:
- Complying with HIPAA and the Authority’s Privacy and Confidentiality Rules and security protections for the patient in connection with the telemedicine or telehealth communication and related records requirements (OAR chapter 943 division 14 and 120, OAR 410-120-1360 and 1380, 42 CFR Part 2, if applicable, and ORS 646A.600 to 646A.628 (Oregon Consumer Identity Theft Protection Act) except as noted in section (16) below;
- Obtaining and maintaining technology used in telemedicine or telehealth communication that is compliant with privacy and security standards in HIPAA and the Authority’s Privacy and Confidentiality Rules described in subsection (A) except as noted in section (16) below;
- Developing and maintaining policies and procedures to prevent a breach in privacy or exposure of client or member health information or records (whether oral or recorded in any form or medium) to unauthorized persons and timely breach reporting;
- Maintaining clinical and financial documentation related to telemedicine or telehealth services as required in OAR 410-120-1360 and any program specific rules in OAR Ch 309 and Ch 410;
- Complying with all federal and state statutes as required in OAR 410-120-1380.
The Authority will only pay for telemedicine or telehealth services meeting all of the following requirements:
- Services provided shall be medically and clinically appropriate for covered conditions within the Health Evidence Review Commission’s (HERC) prioritized list and in compliance with relevant guideline notes;
- The Authority shall provide reimbursement for telemedicine or telehealth services at the same reimbursement rate as if it were provided in person. As a condition of reimbursement, providers shall agree to reimburse Certified and Qualified Health Care Interpreters (HCIs) for interpretation services provided via telemedicine or telehealth at the same rate as if interpretation services were provided in-person, per OARs 410-141-3515(12) and 410-141-3860(12).
- When allowed by individual certification or licensing boards’ scope of practice standards, telemedicine or telehealth delivered services for covered conditions are covered:
- When an established relationship exists between a provider and client or member defined as a client or member who has received in-person professional services from the physician or other qualified health care professional within the same practice within the past three years; and
- For establishing a client or member-provider relationship.
- All physical and behavioral telemedicine or telehealth, and oral teledentristy services except School Based Health Services (SBHS) shall include Place of Service code 02.
- All claim types except Dental services, shall use modifiers GT or 95 when the telemedicine or telehealth delivered service utilizes a synchronous audio and video modality. When provision of the same service via synchronous audio and video is not available or feasible (e.g., the client or member declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in client or member’s medical record) the claim should not include any modifiers but should continue billing Place of Service as 02.
SOURCE: OAR 410-120-1990, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Teledentistry
All billing requirements apply to all delivery modalities (live video, store and forward, remote patient monitoring and mobile communication devices). Payment for dental services may not distinguish between services performed using teledentistry, real time, or store-and-forward and services performed in-person.
The dentist who completes diagnosis and treatment planning and the oral evaluation documents these services using the traditional CDT codes, and also reports D9995 or D9996 as appropriate.
An assessment-D0191 is a limited inspection performed to identify possible signs of oral or systemic disease, malformation or injury, and the potential need for referral for diagnosis and treatment. This code may be billed using the modality of teledentistry:
- When D0191 is reported in conjunction with an oral evaluation (D0120-D0180) using teledentistry, D0191 shall be disallowed even if done by a different provider;
- The assessment and evaluation may not be billed or covered by both the originating site dental care provider and a distant site dentist using the modality of teledentistry, even if due to store-and-forward review, if the dates of services are on different days.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
Behavioral Health
Behavioral health services identified as allowable for telephonic delivery are listed in the fee schedule. See fee schedule for list of covered telehealth services.
For purposes of behavioral health services, the Authority shall provide coverage for telemedicine services to the same extent that the services would be covered if they were provided in person.
SOURCE: OR OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health, (Accessed Jul. 2023).
Behavioral Health Resource Networks
A comprehensive BHRN must include at minimum the required services below to be funded by the OAC. These services may be provided by one or more entities who refer between and collaborate with each other. To be a BHRN, a BHRN must provide, and maintain sufficient capacity to provide, the following services and supports to individuals who use substances that cause harm or have a substance use disorder in the BHRN’s county or region:
- Screening must be conducted by PSS, CRM, PWS or other addiction professional. Screening service must be available 24 hours a day, seven days a week, every calendar day of the year. Screening must be made available to each individual immediately upon first contact. At least one organization within each BHRN within each county or region must meet this requirement: …
- Services must be offered face-to-face or through telehealth. The modality must be based on the needs and preference of the individual as well as any safety concerns identified by the individual or the BHRN.
See rule for additional information.
SOURCE: OR OAR 944-001-0020, Oversights and Accountability Council, Behavioral Resource Networks, (Accessed Jul. 2023).
School Based Health Services
Oregon Health Authority reimburses for all the same covered services outlined in OAR 410-133-0080 when furnished through telehealth (See OAR 410-133-0080):
Screening must be conducted by PSS, CRM, PWS or other addiction professional. Screening service must be available 24 hours a day, seven days a week, every calendar day of the year. Screening must be made available to each individual immediately upon first contact. At least one organization within each BHRN within each county or region must meet this requirement:
- Be provided by a licensed practitioner/clinician employed by or contracted by an Oregon public school district or Education Service District, enrolled with Oregon Health Authority (OHA) as a “school medical (SM)” provider with authority to provide SBHS to Oregon Medicaid beneficiaries;
- Be performed by or under a supervising licensed practitioner/clinician within the scope of practice governed by their licensing board, who meet the federal requirements as described in medically qualified staff in OAR 410-133-0120, and who hold a current and valid license without restriction from a state licensing board where the provider is located;
- Use synchronous audio and visual interactive technologies, including interactive audio/telephonic services provided to a child/student in a geographical area where synchronous audio and video is not available or consent for audio/video is refused for services provided to a child/student;
- Include, when applicable, electronic or telephonic communications such as telephone conversation, video conference, or an internet relay chat session for care coordination defined in OAR 410-133-0040(16);
- Assist the licensed practitioner/clinician with care coordination and oversight of a Medicaid eligible child/student’s covered health related services provided in support of a child/student’s education program required by the Individuals with Disabilities Education Act (IDEA);
- Be compliant with applicable privacy rules and security protections for the child/student in connection with the telehealth communication and confidentiality related to records required by HIPAA and FERPA;
- Ensure the telehealth communication obtained, used and maintained is compliant with privacy and security standards in HIPAA and the Authority’s Privacy and Confidentiality Rules set forth in OAR 943 division 14;
- Ensure policies and procedures are in place to prevent a breach in privacy or exposure of protected health information or records (whether oral or recorded in any form or medium) to unauthorized individuals.
Providers billing Medicaid for SBHS health related services via telehealth must:
- Align services provided within a licensed practitioner/clinician scope of practice governed by their licensing board;
- Obtain the child’s/student’s parent or guardian’s written or verbal consent to receive the services via telehealth technologies, prior to the delivery of health-related services to an eligible child/student with disabilities using a telehealth modality. Verbal consent must be documented/noted in the child’s plan of care by the practitioner. Consent must be obtained and documented annually or with change in services on the child/students plan of care;
- Model SOAP charting or equivalent for covered health related services required by the Individuals with Disabilities Education Act (IDEA) in compliance with Documentation and Recordkeeping Requirements OAR 410-133-0320;
- Describe services provided as telehealth synchronous audio/visual interactive equivalent to face to face; or electronic/telephonic interactive communication described as telephone conversation, video conference, or internet relay chat requiring decision making for coordinating care;
- Bill Medicaid using the most appropriate Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) codes and modifiers for SBHS considered as an OHP covered service. A two-digit modifier assigned to telehealth is required for billing SBHS telehealth services using audio and video interactive technologies;
- For services covered using synchronous audio and video with modifiers GT, the Division will cover the same services provided by synchronous audio (e.g. telephone), when billed with the same codes but without modifier GT when provision of the same service via synchronous audio and video is not available or feasible, when the patient declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in the child/student’s plan of care;
- Maintain clinical documentation and financial records related to telehealth services as required in OAR 410-120-1360 and these SBHS Rules.
During an emergency declaration, the Authority may reimburse any necessary and appropriate physical, mental, behavioral and oral health service delivered using a telehealth platform when the telehealth delivery reasonably approximates in person services to maximize access to services and reduce barriers in the delivery of these services provided to eligible children included in a child’s Individualized Education Program (IEP) or Individualized family Service Plan (IFSP) required by the Individuals with Disabilities Education Act (IDEA), a Section 504 plan pursuant to Section 504 of the Rehabilitation Act, or other school services plan. Other types of telecommunications are not covered, without necessary and appropriate decision making for an eligible child’s /student’s plan of care.
For services covered using synchronous audio and video with modifiers GT, the Division will cover the same services provided by synchronous audio (e.g. telephone), when billed with the same codes but without modifier GT when provision of the same service via synchronous audio and video is not available or feasible, when the patient declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in the child/student’s plan of care.
SOURCE: OR OAR 410-133-0080, Health Systems Division: Medical Assistance Programs, School-Based Health Services, Coverage (Accessed Jul. 2023).
Reproductive Health Access Program
Covered services provided by telehealth technology may be billed to the RH Program, as appropriate. The CVR must indicate that the visit was conducted via telehealth. All telehealth visits must adhere to applicable state and federal telehealth regulations.
SOURCE: OR OAR 333-004-3110, RH Access Fund Billing and Claims (Accessed Jul. 2023).
Linguistic and Cultural Access
MCEs shall ensure that telemedicine or telehealth services provided are culturally and linguistically appropriate as described in the relevant standards:
- National Culturally and Linguistically Appropriate Services (CLAS) Standards;
- Tribal based practice standards;
- Trauma-informed approach to care as defined in 410-141-3500.
MCEs shall ensure that providers offer meaningful access to health care services for members and their families who experience LEP or hearing impairments by working with qualified or certified health care interpreters to provide language access services as described in OAR 333-002-0040. Such services shall not be significantly restricted, delayed, or inferior as compared to programs or activities provided to English proficient individuals.
MCEs shall ensure that providers collaborate with members to identify modalities for delivering health care services which best meets the needs of the member and considers the member’s choice and readiness for the modality of service selected.
SOURCE: OAR 410-141-3566. Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telemedicine and Telehealth Delivered Health Service and Reimbursement Requirements. (Accessed Jul. 2023).
Newborn Nurse Home Visiting Service Requirements
If a family declines home visiting services in their home, an alternate location may be offered, and telemedicine services must be offered and delivered in accordance with ORS 743A.058. Declination of home visiting services in the home must be documented in the client’s medical record.
SOURCE: OAR 333-006-0120, Health Systems Division: Public Health Division, Universally Offered Newborn Nurse Home Program, (Accessed Jul. 2023).
Health benefit plans must reimburse at the case rate for newborn nurse home visiting services conducted via telemedicine pursuant to OAR 333-006-0120 and ORS 743A.058.
SOURCE: OAR 333-006-0190, Health Systems Division: Public Health Division, Universally Offered Newborn Nurse Home Program, (Accessed Jul. 2023).
ELIGIBLE PROVIDERS
Telehealth providers shall meet the following requirements:
Shall be enrolled with the Authority as an Oregon Health Plan (OHP) provider, per 410-120-1260.
Shall provide services via telemedicine or telehealth that are within their respective certification or licensing board’s scope of practice and comply with telmedicine or telehealth requirements including, but not limited to:
- Documenting patient and provider agreement of consent to receive services;
- Allowed physical location of provider and patient;
- Establishing or maintaining an appropriate provider-patient relationship.
The Authority will only pay for telemedicine or telehealth services meeting all of the following requirements:
- Services provided shall be medically and clinically appropriate for covered conditions within the Health Evidence Review Commission’s (HERC) prioritized list and in compliance with relevant guideline notes;
- The Authority shall provide reimbursement for telemedicine or telehealth services at the same reimbursement rate as if it were provided in person. As a condition of reimbursement, providers shall agree to reimburse Certified and Qualified Health Care Interpreters (HCIs) for interpretation services provided via telemedicine or telehealth at the same rate as if interpretation services were provided in-person, per OARs 410-141-3515(12) and 410-141-3860(12).
- When allowed by individual certification or licensing boards’ scope of practice standards, telemedicine or telehealth delivered services for covered conditions are covered:
- When an established relationship exists between a provider and client or member defined as a client or member who has received in-person professional services from the physician or other qualified health care professional within the same practice within the past three years; and
- For establishing a client or member-provider relationship.
- All physical and behavioral telemedicine or telehealth, and oral teledentristy services except School Based Health Services (SBHS) shall include Place of Service code 02.
- All claim types except Dental services, shall use modifiers GT or 95 when the telemedicine or telehealth delivered service utilizes a synchronous audio and video modality. When provision of the same service via synchronous audio and video is not available or feasible (e.g., the client or member declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in client or member’s medical record) the claim should not include any modifiers but should continue billing Place of Service as 02.
Pursuant to Title VI of the Civil Rights Act of 1964, Section 1557 of the Affordable Care Act and the corresponding Federal Regulation at 45 CFR Part 92 and The Americans with Disabilities Act (ADA), providers’ telemedicine or telehealth services shall accommodate the needs of individuals who have difficulty communicating due to a medical condition, who need accommodation due to a disability, advanced age or who have Limited English Proficiency (LEP) including providing access to auxiliary aids and services as described in 45 CFR Part 92;
- National Culturally and Linguistically Appropriate Services (CLAS) Standards at https://thinkculturalhealth.hhs.gov/clas/standards; and
- As applicable to the client or member, Tribal based practice standards: https://www.oregon.gov/OHA/HSD/AMH/Pages/EBP.aspx;
SOURCE: OAR 410-120-1990, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
Dentists providing Medicaid services shall be licensed to practice dentistry within the State of Oregon or within the contiguous area of Oregon and shall be enrolled as a Health Systems Division (Division) provider.
Providers billing covered teledentistry/telehealth services are responsible for complying with specific standards. See rule for teledentistry/telehealth services requirements for providers billing.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
See rule for requirements for providers billing behavioral health services.
SOURCE: OAR 410-172-0850, Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health). (Accessed Jul. 2023).
School Based Health Services
Must be provided by a licensed practitioner/clinician employed by or contracted by an Oregon public school district or Education Service District, enrolled with Oregon Health Authority (OHA) as a “school medical (SM)” provider with authority to provide SBHS to Oregon Medicaid beneficiaries.
Must also be performed by or under a supervising licensed practitioner/clinician within the scope of practice governed by their licensing board, who meet the federal requirements as described in medically qualified staff in OAR 410-133-0120, and who hold a current and valid license without restriction from a state licensing board where the provider is located. See OAR 410-133-0140 for additional provider requirements.
SOURCE: OR OAR 410-133-0080, Health Systems Division: Medical Assistance Programs, School-Based Health Services, Definitions (Accessed Jul. 2023).
MCEs shall provide reimbursement for telemedicine or telehealth services and reimburse Certified and Qualified Health Care Interpreters (HCIs) as defined in OAR 950-050-0010 for interpretation services provided via telemedicine at the same reimbursement rate as if it were provided in person. This requirement does not supersede the MCEs direct agreement(s) with providers, including but not limited to, alternative payment methodologies, quality and performance measures or Value Based Payment methods described in the MCE contract. However, nothing either in this requirement or within MCE direct agreement(s) with providers referenced herein supersedes any federal or state requirements with regard to the provision and coverage of health care interpreter services.
MCEs shall ensure that providers offer meaningful access to telemedicine/telehealth services by completing a capacity assessment of members in the use of specific approved methods of telemedicine or telehealth delivery that comply with accessibility standards including alternate formats, and provides the optimal quality of care for the member given considerations of member access to necessary devices, access to a private and safe location, adequate internet, digital literacy, cultural appropriateness of telemedicine or telehealth services, and other considerations of member readiness to use telemedicine or telehealth.
SOURCE: OAR 410-141-3566, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telemedicine and Telehealth Delivered Health Service and Reimbursement Requirements. (Accessed Jul. 2023).
Dental Care Benefits for Pregnant Individuals
Pregnant clients shall be seen, treated in person or via teledentistry for an OHP-covered service within the following time frames:
- For emergency dental care: within 24 hours;
- For urgent dental care: within one week.
- For routine dental care: within four weeks, unless there is a documented special clinical reason that would make access longer than four weeks appropriate;
- For initial dental screening or examination: four weeks.
SOURCE: OAR 410-123-1510, Health Systems Division: Medical Assistance Programs, Dental/Denturist Services. (Accessed Jul. 2023).
ELIGIBLE SITES
The patient may be in the community or in a health care setting.
The provider may be in any location in which appropriate privacy and confidentiality can be ensured.
The Authority will only pay for telemedicine or telehealth services meeting all of the following requirements:
- Services provided shall be medically and clinically appropriate for covered conditions within the Health Evidence Review Commission’s (HERC) prioritized list and in compliance with relevant guideline notes;
- The Authority shall provide reimbursement for telemedicine or telehealth services at the same reimbursement rate as if it were provided in person. As a condition of reimbursement, providers shall agree to reimburse Certified and Qualified Health Care Interpreters (HCIs) for interpretation services provided via telemedicine or telehealth at the same rate as if interpretation services were provided in-person, per OARs 410-141-3515(12) and 410-141-3860(12).
- When allowed by individual certification or licensing boards’ scope of practice standards, telemedicine or telehealth delivered services for covered conditions are covered:
- When an established relationship exists between a provider and client or member defined as a client or member who has received in-person professional services from the physician or other qualified health care professional within the same practice within the past three years; and
- For establishing a client or member-provider relationship.
- All physical and behavioral telemedicine or telehealth, and oral teledentristy services except School Based Health Services (SBHS) shall include Place of Service code 02.
- All claim types except Dental services, shall use modifiers GT or 95 when the telemedicine or telehealth delivered service utilizes a synchronous audio and video modality. When provision of the same service via synchronous audio and video is not available or feasible (e.g., the client or member declines to enable video, or necessary consents cannot reasonably be obtained with appropriate documentation in client or member’s medical record) the claim should not include any modifiers but should continue billing Place of Service as 02.
SOURCE: OAR 410-120-1990, Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
The authority shall include the costs of telemedicine services in its rate assumptions for payments made to clinics or other providers on a prepaid capitated basis.
SOURCE: OR Statute Ch. 414.723, (Accessed Jul. 2023).
School-Based Health Services
Telehealth may occur between an alternate site such as the child/student’s home, childcare facility, or other public education programs and settings, and the distant site setting of the practitioner/clinician. Telehealth can be interactive audio/telephonic services provided to a child/student in a geographical area where synchronous audio and video is not available or consent for audio/video is refused for services provided to a child/student. Telehealth may include coordinated care defined in Definitions 410-133-0040(16).
SOURCE: OR OAR 410-133-0040, Health Systems Division: Medical, School-Based Services. (Accessed Jul. 2023).
The originating site may bill a CDT code only if a separately identifiable service is performed within the scope of practice of the practitioner providing the service. The service must meet all criteria of the CDT code billed.
The assessment and evaluation may not be billed or covered by both the originating site dental care provider and a distant site dentist using the modality of teledentistry, even if due to store-and-forward review, if the dates of services are on different days.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
GEOGRAPHIC LIMITS
No Reference Found
FACILITY/TRANSMISSION FEE
The originating site code Q3014 is covered only when the patient is present in an appropriate health care setting and receiving services from a provider in another location.
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-3. (1/29/23). (Accessed Jul. 2023).
Last updated 07/31/2023
Miscellaneous
Teledentistry
Providers billing for covered teledentistry/telehealth services are responsible for (A) through (D) above, as well as:
- A patient receiving services through teledentistry shall be notified of the right to receive interactive communication with the distant dentist and shall receive an interactive communication with the distant dentist upon request;
- The patient’s chart documentation shall reflect notification of the right to interactive communication with the distant site dentist;
- A patient may request to have real time communication with the distant dentist at the time of the visit or within 30 days of the original visit.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
Providers offering telemedicine or telehealth services, must meet the following requirements:
- Complying with HIPAA and the Authority’s Privacy and Confidentiality Rules and security protections for the member in connection with the telemedicine or telehealth communication and related records requirements (OAR chapter 943 division 14 and 120, OAR 410-120-1360 and 1380, 42 CFR Part 2, if applicable, and ORS 646A.600 to 646A.628 (Oregon Consumer Identity Theft Protection Act)) except as noted in section (9) below;
- Obtaining and maintaining technology used in telemedicine/telehealth communication that is compliant with privacy and security standards in HIPAA and the Authority’s Privacy and Confidentiality Rules described in subsection (b) except as noted in section (9) below;
- Ensuring policies and procedures are in place to prevent a breach in privacy or exposure of member health information or records (whether oral or recorded in any form or medium) to unauthorized persons and timely breach reporting as described in OAR 943-014-0440;
- Maintaining clinical and financial documentation related to telemedicine or telehealth services as required in OAR 410-120-1360 and any program specific rules in OAR Ch 309 and Ch 410;
- Complying with all federal and state statutes as required in OAR 410-120-1380.
Providers must also ensure services are within their respective certification or licensing board’s scope of practice and comply with telehealth requirements. See rules for details.
SOURCE: OAR 410-141-3566 Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Telehealth Service and Reimbursement Requirements. (Accessed Jul. 2023).
Network Adequacy
MCEs shall have an access plan that establishes a protocol for monitoring and ensuring access, outlines how provider capacity is determined, and establishes procedures for monthly monitoring of capacity and access and for improving access and managing access in times of reduced participating provider capacity. The access plan and associated monitoring protocol shall address the following: …
- The availability of telemedicine within the MCE’s contracted provider network.
SOURCE: OAR 410-141-3515 Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Network Adequacy. (AccessedJul. 2023).
“Meaningful access” means member-centered access reflecting the following statute / and standards:
- Pursuant to Title VI of the Civil Rights Act of 1964, Section 1557 of the Affordable Care Act and the corresponding Federal Regulation at 45 CFR Part 92 and The Americans with Disabilities Act (ADA), providers’ telemedicine or telehealth shall accommodate the needs of individuals who have difficulty communicating due to a medical condition, who need accommodation due to a disability, advanced age or who have Limited English Proficiency (LEP) and including providing access to auxiliary aids and services as described in Federal Regulation at 45 CFR Part 92;
- National Culturally and Linguistically Appropriate Services (CLAS) Standards
- Tribal based practice standards
SOURCE: 410-141-3566 Health Systems Division: Medical Assistance Programs, Oregon Health Plan, (Accessed Jul. 2023).
“Face to Face” means a personal interaction where both words can be heard and facial expressions can be seen in person or through telehealth services where there is a live streaming audio and video, if medically appropriate.
SOURCE: OAR 410-172-0600 Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services. (Accessed Jul. 2023).
Last updated 07/31/2023
Out of State Providers
The Authority may expand network capacity through remote care and telemedicine, or telehealth services provided across state lines.
SOURCE: OR OAR 410-120-1990 (Accessed Jul. 2023).
A provider located in a state other than Oregon whose services are rendered in that state shall be licensed and otherwise certified by the proper agencies in the state of residence as qualified to render the services. Certain cities within 75 miles of the Oregon border may be closer for Oregon residents than major cities in Oregon, and therefore, these areas are considered contiguous areas, and providers are treated as providing in-state services. See rule for additional requirements.
SOURCE: OR OAR 410-120-1180 (Accessed Jul. 2023).
Last updated 07/31/2023
Overview
OR Health Authority covers telehealth and telemedicine services. The definitions of which encompass video conferencing, store-and-forward imaging, streaming media including services with information transmitted via landlines, and wireless communications, including the Internet and telephone networks. Services must be culturally and linguistically appropriate.
Last updated 07/31/2023
Remote Patient Monitoring
POLICY
To encourage the efficient use of resources and to promote cost-effective procedures in accordance with ORS 413.011 (1)(L), the Oregon Health Authority shall reimburse the cost of health services delivered using telemedicine, including but not limited to:
- Health services transmitted via landlines, wireless communications, the Internet and telephone networks;
- Synchronous or asynchronous transmissions using audio only, video only, audio and video and transmission of data from remote monitoring devices; and
- Communications between providers or between one or more providers and one or more patients, family members, caregivers or guardians.
The authority shall pay the same reimbursement for a health service regardless of whether the service is provided in person or using any permissible telemedicine application or technology.
SOURCE: OR Statute 414.723. (Accessed Jul. 2023).
Oregon will reimburse “dental care providers” for ‘remote patient monitoring’, which is defined as “personal health and dental information is collected by dental care providers in one location then transmitted electronically to a dentist in a distant site location for use in care”
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
“Asynchronous” means not simultaneous or concurrent in time. For the purpose of this rule, asynchronous telecommunication technologies for telemedicine or telehealth services may include audio and video, audio, or member portal and may include transmission of data from remote monitoring. “Asynchronous” does not include voice messages, facsimile, electronic mail or text messages.
SOURCE: OAR 410-141-3566. Health Systems Division: Medical Assistance Programs. Oregon Health Plan and 410-120-1990 (Accessed Jul. 2023).
CONDITIONS
No Reference Found
PROVIDER LIMITATIONS
No Reference Found
OTHER RESTRICTIONS
No Reference Found
Last updated 07/31/2023
Store and Forward
POLICY
To encourage the efficient use of resources and to promote cost-effective procedures in accordance with ORS 413.011 (1)(L), the Oregon Health Authority shall reimburse the cost of health services delivered using telemedicine, including but not limited to:
- Health services transmitted via landlines, wireless communications, the Internet and telephone networks;
- Synchronous or asynchronous transmissions using audio only, video only, audio and video and transmission of data from remote monitoring devices; and
- Communications between providers or between one or more providers and one or more patients, family members, caregivers or guardians.
The authority shall pay the same reimbursement for a health service regardless of whether the service is provided in person or using any permissible telemedicine application or technology.
SOURCE: OR Revised Statutes Sec. 414.723, (Accessed Jul. 2023).
Coverage of interprofessional consultations delivered online, through electronic health records or by telephone is included as follows:
- (CPT 99446-99449, 99451-99451)
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-3. (1/29/23). (Accessed Jul. 2023).
Behavioral Health Services:
Unless specifically authorized by OAR 410-120-1200 other types of telecommunication are not covered such as images transmitted via facsimile machines and electronic mail when:
- Those methods are not being used in lieu of videoconferencing, due to limited video conferencing equipment access; or
- Those methods and specific services are not specifically allowed pursuant to the Oregon Health Evidence Review Commission’s Prioritized List of Health Services and Evidence Based Guidelines.
SOURCE: 410-172-0850 Health Systems Division: Medical Assistance Programs, Medicaid Payment for Behavioral Health Services, Telemedicine for Behavioral Health. (Accessed Jul. 2023).
Teledentistry
Teledentistry can take multiple forms, including ‘store and forward’, defined as “an asynchronous transmission of recorded health information such as radiographs, photographs, video, digital impressions, or photomicrographs transmitted through a secure electronic communication system to a dentist, and it is reviewed at a later point in time by a dentist. The dentist at a distant site reviews the information without the patient being present in real time.”
The assessment and evaluation may not be billed or covered by both the originating site dental care provider and a distant site dentist using the modality of teledentistry, even if due to store-and-forward review, if the dates of services are on different days.
Unless authorized in OAR 410-120-1200 Exclusions or OAR 410-120-1990, other types of telecommunications such as telephone calls, images transmitted via facsimile machines, and electronic mail are not covered:
- When those types are not being used in lieu of teledentistry, due to limited teledentistry equipment access; or
- When those types and specific services are not specifically allowed in this rule per the Oregon Health Evidence Review Commission’s Prioritized List of Health Services.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
“Asynchronous” means not simultaneous or concurrent in time. For the purpose of this rule, asynchronous telecommunication technologies for telemedicine or telehealth services may include audio and video, audio, or member portal and may include transmission of data from remote monitoring. “Asynchronous” does not include voice messages, facsimile, electronic mail or text messages.
Communications may be between providers, or between one or more providers and one or more members, family members /caregivers /guardians.
SOURCE: OAR 410-141-3566, Health Systems Division: Medical Assistance, Oregon Health Plan, Telehealth Service and Reimbursement Requirements & OAR 410-120-1990 Health Systems Division: Medical Assistance Programs, Telehealth. (Accessed Jul. 2023).
ELIGIBLE SERVICES/SPECIALTIES
HERC prioritized list indicate interprofessional consultation codes through EHRs are reimbursable.
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-3. (1/29/23). (Accessed Jul. 2023).
Teledentistry
A dentist may collect the transmission of recorded health information such as radiographs, photographs, video, digital impressions, or photomicrographs transmitted through a secure electronic communication system to a dentist, and it is reviewed at a later point in time by a dentist. The dentist at a distant site reviews the information without the patient being present in real time.
Payment for dental services may not distinguish between services performed using teledentistry, real time, or store-and-forward and services performed in-person.
SOURCE: OR OAR 410-123-1265, Health Systems Division: Medical Assistance Programs, Oregon Health Plan, Teledentistry. (Accessed Jul. 2023).
GEOGRAPHIC LIMITS
No Reference Found
TRANSMISSION FEE
The originating site code Q3014 is covered only when the patient is present in an appropriate health care setting and receiving services from a provider in another location.
SOURCE: Oregon Health Authority, Health Evidence Review Commission, Guideline Note Changes for the Feb. 1, 2023 Prioritized List of Health Services, p. AD-3. (1/29/23). (Accessed Jul. 2023).