March 25, 2020 Notice of Temporary Changes to Workers’ Compensation Rules Caption: Fees for telephonic and digital evaluation and management services during COVID- 19-related care limitations The Workers’ Compensation Division has adopted temporary changes to OAR 436-009, to be effective March 25, 2020*. Summary of changes: Amended rule 0040 increases maximum allowable payments for certain telephonic and digital evaluation/management services delivered on or after March 8, 2020, the date of the Governor’s Executive Order 20-03, “Declaration of emergency due to coronavirus (COVID-19) outbreak in Oregon.” Need for the Temporary Rule(s): Temporary rules are needed to increase payment for certain digital services and telephone visits between workers and their health care providers, and promote communication about the progress of recovery, when in-person care or telemedicine (two-way video) services are not possible or are unavailable. The Oregon Health Authority has recommended that reimbursement rates for telehealth services mirror payment rates for equivalent office visits. Documents Relied Upon, and where they are available: Executive orders of Gov. Kate Brown regarding COVID-19 and the “Telehealth Guidance” document issued jointly by the Department of Consumer and Business Services and the Oregon Health Authority. These documents are available for public inspection upon request to the Workers’ Compensation Division, 350 Winter Street NE, Salem, Oregon 97301-3879. Please contact Fred Bruyns, rules coordinator, 503-947-7717, [email protected]. Justification of Temporary Rule(s): Failure to act promptly will result in serious prejudice to the public interest or the interest of the parties concerned. COVID-19-related actions to promote social distancing have disrupted workers’ ability to receive in-person care for their job-related injuries and illnesses. Continuity of care is essential to monitor the progress of recovery, including whether any temporary total disability should continue and when the worker may return to modified or regular work. Treatment delays impede recovery and may increase claims costs. Increasing reimbursement for remote services to levels equivalent to in-person care should promote use of these alternatives to in-office care. The agency finds that issuing temporary rules under ORS 183.335(5) is appropriate because the need for alternatives to in-person care is immediate. Executive Order 20-10, stated in part: “No later than March 23, 2020, all elective and non-urgent procedures across all care settings that utilize PPE [personal protective equipment] … shall be cancelled, or rescheduled no earlier than June 15, 2020 ….” In addition, Executive Order 20-12 requires “…social distancing of at least six feet from any person who is not a member of their immediate household, to the greatest extent possible…” As a result, many medical clinics and facilities are closing or severely restricting in-person appointments. *[Revised telehealth reimbursement maximums will remain in effect through Sept. 20, 2020, unless rule 0040 is replaced by a permanent rule.]
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Notice of Temporary Changes to Workers’ Compensation Rules · Notice of temporary rulemaking Page 2 The agency finds that issuing permanent rules under ORS 183.335(2) and (3) is
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March 25, 2020
Notice of Temporary Changes to Workers’ Compensation Rules
Caption: Fees for telephonic and digital evaluation and management services during COVID-
19-related care limitations
The Workers’ Compensation Division has adopted temporary changes to OAR 436-009,
to be effective March 25, 2020*.
Summary of changes:
Amended rule 0040 increases maximum allowable payments for certain telephonic and digital
evaluation/management services delivered on or after March 8, 2020, the date of the Governor’s
Executive Order 20-03, “Declaration of emergency due to coronavirus (COVID-19) outbreak in
Oregon.”
Need for the Temporary Rule(s): Temporary rules are needed to increase payment for certain digital
services and telephone visits between workers and their health care providers, and promote
communication about the progress of recovery, when in-person care or telemedicine (two-way video)
services are not possible or are unavailable. The Oregon Health Authority has recommended that
reimbursement rates for telehealth services mirror payment rates for equivalent office visits.
Documents Relied Upon, and where they are available: Executive orders of Gov. Kate Brown
regarding COVID-19 and the “Telehealth Guidance” document issued jointly by the Department of
Consumer and Business Services and the Oregon Health Authority. These documents are available for
public inspection upon request to the Workers’ Compensation Division, 350 Winter Street NE, Salem,
Oregon 97301-3879. Please contact Fred Bruyns, rules coordinator, 503-947-7717,
If you have questions, call the Workers’ Compensation Division, 503-947-7606.
The five character codes included in the Oregon Workers’ Compensation Maximum Allowable Payment Tables are obtained from Current Procedural Terminology (CPT), copyright 2018 and 2019 by the American Medical Association (AMA). CPT is developed by the AMA as a listing of descriptive terms and five character identifying codes and modifiers for reporting medical services and procedures.
The responsibility for the content of Oregon Workers’ Compensation Maximum Allowable Payment Tables is with State of Oregon and no endorsement by the AMA is intended or should be implied. The AMA disclaims responsibility for any consequences or liability attributable or related to any use, nonuse or interpretation of information contained in Oregon Workers’ Compensation Maximum Allowable Payment Tables. Fee schedules, relative value units, conversion factors and related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Any use of CPT outside of Oregon Workers’ Compensation Maximum Allowable Payment Tables should refer to the most current Current Procedural Terminology which contains the complete and most current listing of CPT codes and descriptive terms. Applicable FARS/DFARS apply. CPT only copyright 2018 and 2019 American Medical Association. All rights reserved.
Link to the Maximum Allowable Payment Tables: http://wcd.oregon.gov/medical/Pages/disclaimer.aspx
Or, contact the division for a paper copy, 503-947-7717