Or. Admin. Code § 410-129-0075
Current through Register Vol. 64, No. 1, January 1, 2025
Section 410-129-0075 - Face-to-Face Encounter Requirements for Fee-for-Service Clients(1) For initial ordering of speech generating devices (SGD), an in-person, face-to-face encounter that is related to the primary reason the client requires the medical equipment or supplies must occur no more than six months prior to the start of services: (a) The face-to-face encounter shall be conducted and documented by the treating physician (MD or DO) or an authorized non-physician practitioner (NPP);(b) Authorized NPPs for SGD are nurse practitioners, clinical nurse specialists working in collaboration with a physician, or physician assistants under the supervision of a physician;(c) The physician or NPP conducting the face-to-face encounter shall document that the client is evaluated or treated for a condition that supports the need for the SGD ordered within six months prior to completing the written order for the equipment;(d) If the NPP performing the face-to-face encounter does not have prescribing authority, the NPP shall communicate the clinical findings to the ordering physician;(e) The ordering physician shall incorporate the clinical findings into a written or electronic document included in the client's medical record.(2) If a dually eligible client is evaluated for medical equipment or supplies under Medicare and transitions to Medicaid, the Medicare face-to-face encounter documentation shall meet the Medicaid face-to-face requirement.(3) The durable medical equipment (DME) supplier shall maintain documentation of the qualifying face-to-face encounter and provide the documentation when the item requires PA or at the Division's request.Or. Admin. Code § 410-129-0075
DMAP 30-2018, temporary adopt filed 05/17/2018, effective 05/17/2018 through 11/12/2018; DMAP 100-2018, adopt filed 11/06/2018, effective 11/6/2018Statutory/Other Authority: ORS 413.042 & ORS 414.065
Statutes/Other Implemented: ORS 414.065