Mental Health Provider
The ICD-10 Prioritized List can be found at the following webpage: http://www.oregon.gov/oha/healthplan/Pages/icd10.aspx
A searchable version of the Prioritized List of Health Services is available here.
- Clinical Guidelines
- Medical Necessity addendum - CATC admission (34 KB)
- Health Share of Oregon Behavioral Health Provider Manual
- Health Share of Oregon Provider Authorization Guides and Forms
Mental health reporting forms
Complaint forms for OHP and non-OHP members are located on the Get Informed page. Forms in additional languages are available upon request.
Mental health provider contract exhibit forms (used by providers operating with a Multnomah MHASD Cost Reimbursement Contract)
- Invoice Template - Exhibit 6A (you may request an excel version of the invoice by emailing MHASD business services at: firstname.lastname@example.org)
- Cost Reimbursement Budget - Exhibit 6C
Mental health treatment request forms
To request psychological evaluations, please complete a (PTAR) form and submit supporting clinical documentation. The following information should be included for the request to be considered for review:
1. PTAR with completed supplemental questions.
2. Mental Health Assessment (within last 60 days); updated treatment plan and needs.
3. Submit any additional clinical justification and documentation to support request for authorization.
*Neuropsychological Assessments or assessments related to medical conditions are the responsibility of member's capitated medical plan and requests must be made through medical insurance not behavioral/mental health.
Please submit complete requests to Multnomah Mental Health Utilization Review by secure email to URTeam@multco.us or by fax to 503-988-3137.
State and Health Share / Multnomah Mental Health Contracts