To find out whether a specific procedure is potentially covered according to the Prioritized List, providers can:
- Use the HSC List inquiry on the Oregon Medicaid Provider Portal at www.or-medicaid.gov. This inquiry can tell you the specific line placement for the treatment/condition pair; or
- Call the OHP Code Pairing and Prioritized List Hotline at 800-336-6016.
The list prioritizes treatment (procedure code) and condition (diagnosis code) pairs. To use the Prioritized List, you need to know :
- The treatment you want to know about, and
- The condition it would treat.
OHP covers all medically necessary and medically appropriate services for OHP members under age 21. To learn more, visit OHA's ESPDT page.