OAR 410-147-0160: Modifiers

(1) The Division of Medical Assistance Programs (Division) uses HIPAA compliant modifiers for many services. (2) The following conditions require the use of a modifier for all codes: (a) Family Planning Service — FP, Refer to OAR 410-130-0585 Family Planning Services (b) Vaccine for Children — SL or 26, Refer to OAR 410-130-0255(4) (3) When billing for services that are reimbursed outside a clinic’s encounter rate, a clinic must use the required modifier(s) listed in the individual program Administrative Rules. (a) Enhanced Care Services (including extended care) — HK, Refer to OAR 410-147-0120; (b) Assist surgeon for cesarean deliveries for Citizenship Waived Medical (CWM) clients — 80, 81, 82 or AS.