MedicaidCoverageHigh impact
Provider Announcement
Oregon Health Plan·OR · Physical Therapy, Occupational Therapy, Speech Therapy·Provider
Effective date
Apr 21, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) now covers telehealth delivery of physical therapy, occupational therapy, and speech therapy services at parity with in-person rates. Providers must use Place of Service 02 when billing telehealth claims, and must obtain prior authorization only for initial assessments/re-evaluations conducted by phone; all other phone services are covered without prior auth during the COVID-19 emergency.
Action Required
Effective immediately for Oregon OHP members: (1) Billing team must update billing software to recognize Place of Service 02 for all telehealth PT, OT, and speech therapy claims and ensure reimbursement equals in-person rates. (2) For initial assessments and re-evaluations conducted by phone (not synchronous audio/visual), providers must submit prior authorization requests to OHA with supporting documentation describing barriers and assessment methodology; include letter of justification. (3) For all other phone-based services, no prior authorization is required during the COVID-19 emergency. (4) Providers must ensure meaningful language access services (ASL interpretation, spoken language interpretation for LEP patients) are available for all telehealth services per ADA and Section 1557 requirements. (5) Update encounter forms and provider workflows to designate telehealth modality and document Place of Service 02. Failure to use correct Place of Service code or failure to obtain required prior auth for phone assessments may result in claim denials.