OAR 410-125-0121: Contiguous Area Out-of-State Hospitals

Edition: Current OARD snapshotEffective: 2025-06-29Last verified: 2026-09-07

Contiguous area hospitals are out-of-state hospitals located less than 75 miles outside the Oregon border. Unless such hospitals have an agreement or contract with the Agency for specialized services, contiguous area out-of-state hospitals shall receive DRG reimbursement or billed charges whichever is less. The unit value for contiguous out-of-state hospitals shall be set at the final unit value for the 50th percentile of Oregon hospitals (see Inpatient Rate Calculations for Other Hospitals, DRG Rate Methodology OAR 410-125-0141 for the methodology). Contiguous area out-of-state hospitals are also eligible for cost outlier payments. No capital or medical education payments shall be made. The hospital shall receive a disproportionate share reimbursement if eligible (see OAR 410-125-0150).

Official history and status

Statutory/Other Authority: ORS 413.042

Statutes/Other Implemented: ORS 414.065

History: DMAP 55-2025, amend filed 06/26/2025, effective 06/29/2025 DMAP 146-2024, temporary amend filed 12/29/2024, effective 01/01/2025 through 06/29/2025 OMAP 27-2004, f. 4-22-04 cert. ef. 5-1-04 OMAP 16-2004(Temp), f. & cert. ef. 3-15-04 thru 8-15-04 OMAP 58-2003, f. 9-5-03, cert. ef. 10-1-03 HR 53-1991, f. & cert. ef. 11-18-91, Renumbered from 410-125-0840 HR 32-1991(Temp), f. & cert. ef. 7-29-91 HR 28-1991(Temp), f. & cert. ef. 7-1-91 HR 3-1991, f. & cert. ef. 1-4-91 HR 36-1990(Temp), f. 10-29-90, cert. ef. 11-1-90 HR 31-1990(Temp), f. & cert. ef. 9-11-90 HR 21-1990, f. & cert. ef. 7-9-90, Renumbered from 461-015-0570 HR 18-1990(Temp), f. 6-29-90, cert. ef. 7-1-90 AFS 72-1989, f. & cert. ef. 12-1-89, Renumbered from 461-015-0006, 461-015-0020 & 461-015-0124 AFS 49-1989(Temp), f. 8-24-89, cert. ef. 9-1-89 AFS 45-1989, f. & cert. ef. 8-21-89 AFS 37-1989(Temp), f. 6-30-89, cert. ef. 7-1-89 AFS 36-1989(Temp), f. & cert. ef. 6-30-89 AFS 15-1989(Temp), f. 3-31-89, cert. ef. 4-1-89 AFS 7-1989(Temp), f. 2-17-89, cert. ef. 3-1-89 AFS 63-1988, f. 10-3-88, cert. ef. 12-1-88 AFS 47-1988(Temp), f. 7-13-88, cert. ef. 7-1-88 AFS 26-1988, f. 3-31-88, cert. ef. 4-1-88 AFS 12-1988, f. 2-10-88, cert. ef. 6-1-88 AFS 62-1987(Temp), f. 12-30-87, cert. ef. 1-1-88 AFS 46-1987, f. & cert. ef. 10-1-87 AFS 33-1987(Temp), f. & cert. ef. 7-22-87 AFS 61-1986, f. 8-12-86, cert. ef. 9-1-86 AFS 46-1986(Temp), f. 6-25-86, cert. ef. 7-1-86 AFS 52-1985, f. 9-3-85, cert. ef. 10-1-85 AFS 6-1985, f. 1-28-85, cert. ef. 2-1-85 AFS 45-1984, f. & cert. ef. 10-1-84 AFS 1-1984, f. & cert. ef. 1-9-84 AFS 37-1983(Temp), f. & cert. ef. 7-15-83 AFS 60-1982, f. & cert. ef. 7-1-82; Renumbered from 461-015-0120(5) AFS 18-1982(Temp), f. & cert. ef. 3-1-82 AFS 57-1980, f. 8-29-80, cert. ef. 9-1-80 AFS 14-1980, f. 3-27-80, cert. ef. 4-1-80

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Official source: https://secure.sos.state.or.us/oard/