Oregon Administrative Rules
Chapter 836 - DEPARTMENT OF CONSUMER AND BUSINESS SERVICES, INSURANCE REGULATION
Division 53 - HEALTH BENEFIT PLANS
Section 836-053-1615 - Anesthesia-related claims

Universal Citation: OR Admin Rules 836-053-1615

Current through Register Vol. 63, No. 9, September 1, 2024

(1) Out-of-network reimbursement for anesthesia-related claims, including obstetric anesthesia claims, shall be no less than:

(Base units + Time units + Physical status units) x Anesthesia Conversion factor x Q modifier adjustment x CPI adjustment

(2) Out-of-network reimbursement for an anesthesia-related claim that does not have a number of base units published in the CY 2018 Physician Fee Schedule Final Rule shall be reimbursed at a rate calculated with a number of base units agreed upon in good faith by the insurer and provider to be usual and customary for in-network commercial claims, using best efforts to establish a rate within a reasonable amount of time.

Statutory/Other Authority: ORS 743B.287

Statutes/Other Implemented: ORS 743B.287

Disclaimer: These regulations may not be the most recent version. Oregon may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.