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Provider Enrollment Information
 
Terms of Reimbursement

The Terms of Reimbursement (TOR) is the current reimbursement methodology applicable to each provider type. TORs are listed below.

Ambulance Terms of Reimbursement (P-01642)
Ambulatory Surgical Center Terms of Reimbursement (P-01643)
Anesthetist Terms of Reimbursement (P-01644)
Audiology Terms of Reimbursement (P-01645)
Behavioral Treatment Terms of Reimbursement (P-01683)
Blood Banks Terms of Reimbursement (P-01663)
Border-Status Hospitals Terms of Reimbursement (P-01660)
Case Management Terms of Reimbursement (P-01649)
Chiropractor Terms of Reimbursement (P-01650)
Community Recovery Services, 1915(i) Home and Community-Based Services Terms of Reimbursement (P-01640)
Dental / Dental Hygienists Terms of Reimbursement (P-01651)
Family Planning Clinic Terms of Reimbursement (P-01654)
Freestanding End-Stage Renal Disease Provider Terms of Reimbursement (P-01652)
HealthCheck "Other Services" Provider Terms of Reimbursement (P-01656)
HealthCheck "Other Services" WIC Agency Provider Terms of Reimbursement (P-01641)
HealthCheck Screener and Case Management Provider Terms of Reimbursement (P-01657)
Hearing Instrument Specialist Terms of Reimbursement (P-01647)
Home Health Services Terms of Reimbursement (P-01658)
Hospice Terms of Reimbursement (P-01659)
Hospital Terms of Reimbursement (P-01661)
Hospital-Affiliated End-Stage Renal Disease Provider Terms of Reimbursement (P-01653)
Laboratories Terms of Reimbursement (P-01662)
Licensed Midwife Terms of Reimbursement (P-01684)
Medical Supply and Equipment Vendor Terms of Reimbursement (P-01667)
Mental Health / Substance Abuse Services Terms of Reimbursement (P-01668)
Nontribal Federally Qualified Health Center Terms of Reimbursement (P-02098)
Nurse Midwife Terms of Reimbursement (P-01666)
Nurse Practitioner Terms of Reimbursement (P-01669)
Occupational Therapy Terms of Reimbursement (P-01670)
Optometrist / Optician Terms of Reimbursement (P-01671)
Personal Care Terms of Reimbursement (P-01672)
Pharmacy Terms of Reimbursement (P-01673)
Physical Therapy Terms of Reimbursement (P-01674)
Physicians and Physician Assistants Terms of Reimbursement (P-01675)
Podiatrist Terms of Reimbursement (P-01676)
Portable X-Ray Terms of Reimbursement (P-01677)
Prenatal Care Coordination Agency Terms of Reimbursement (P-01678)
Private Duty Nursing Terms of Reimbursement (P-01665)
Private Duty Nursing to Ventilator-Dependent Members Terms of Reimbursement (P-01664)
Rehabilitation Agency Terms of Reimbursement (P-01679)
Rural Health Clinic Terms of Reimbursement (P-01680)
School-Based Services Terms of Reimbursement (P-01681)
Specialized Medical Vehicle Terms of Reimbursement (P-01682)
Speech-Language Pathology Therapy Terms of Reimbursement (P-01648)
Tribal Federally Qualified Health Center Terms of Reimbursement (P-01655)
 
 
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