Read Oregon Medicaid Fee Schedules

Main website for OHP Data and Reports is here. The website for fee schedules is here.

Fee schedule are release quarterly
Oregon's Medicaid fee schedules come in either CSV, PDF, or Excel format; we'll download the CSV versions
File name format is in the form
```
  http://www.oregon.gov/oha/healthplan/DataReportsDocs/[monthname]%20YYYY%20Fee%20Schedule%20-%20CSV.csv
```
monthname is generally Februrary, May, August, November; but is not consistent. Manual checking at the OHP fee schedules website is required.
report_date is not exact
- It is parsed from the URL and uses the 1st of the month
- It is not the actual date of the fee schedule report posted on the fee schedules website



In [1]:

    
library(data.table)
readFS <- function (url) {
    require(data.table, quietly=TRUE)
    require(lubridate, quietly=TRUE)
    x <- strsplit(url, "(%20)|/|-")[[1]]
    i <- grep("20[01][0-9]", x)
    year <- x[i]
    month <- x[i - 1]
    D <- fread(url, colClasses="character", na.strings=c(""))
    old <- names(D)
    new <- tolower(gsub("(\\s+)|(\\n)", "_", old))
    new <- gsub("^proc_code$", "procedure_code", new)
    new <- gsub("mod1|mod_1", "modifier_1", new)
    new <- gsub("mod2|mod_2", "modifier_2", new)
    setnames(D, old, new)
    D <- D[procedure_code != ""]
    D <- D[grep("^[0-9]+$", procedure_code), procedure_code := sprintf("%05d", as.integer(procedure_code))]
    D <- D[, price := as.numeric(gsub("(\\$)|(,)", "", price))]
    D <- D[, effective_date := fast_strptime(effective_date, "%Y%m%d")]
    D <- D[, report_date := as.Date(paste(month, "01", year), format="%B %d %Y")]
    if (!("modifier_2" %in% names(D))) {D <- D[, modifier_2 := NA_character_]}
    if (!("rate_type" %in% names(D))) {D <- D[, rate_type := NA_character_]}
    D[,
      .(procedure_code,
        description,
        modifier_1,
        modifier_2,
        rate_type,
        price,
        effective_date,
        report_date)]
}



In [2]:

    
urlStem <- "http://www.oregon.gov/oha/healthplan/DataReportsDocs/"
fs <- rbindlist(list(
    readFS(paste0(urlStem, "March%202010%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "May%202010%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August%202010%20Fee%20Schedule%20-%20CSV.csv")),
    # readFS(paste0(urlStem, "December%202010%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "February%202011%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "May%202011%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August%202011%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "November%202011%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "February%202012%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "May%202012%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August%202012%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "November%202012%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "March%202013%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August%202013%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "Nov%202013%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "February-March%202014%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "May-June%202014%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August%202014%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "November%202014%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "February-March%202015%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "May%202015%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "August-September%202015%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "December%202015%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "February%202016%20Fee%20Schedule%20-%20CSV.csv")),
    readFS(paste0(urlStem, "April%202016%20Fee%20Schedule%20-%20CSV.csv"))
))
str(fs)









    



Attaching package: 'lubridate'

The following objects are masked from 'package:data.table':

    hour, mday, month, quarter, wday, week, yday, year







    



Classes 'data.table' and 'data.frame':	844662 obs. of  8 variables:
 $ procedure_code: chr  "00100" "00102" "00103" "00104" ...
 $ description   : chr  "ANESTH, SALIVARY GLAND" "ANESTH, REPAIR OF CLEFT LIP" "ANESTH, BLEPHAROPLASTY" "ANESTH, ELECTROSHOCK" ...
 $ modifier_1    : chr  NA NA NA NA ...
 $ modifier_2    : chr  NA NA NA NA ...
 $ rate_type     : chr  NA NA NA NA ...
 $ price         : num  24.2 24.2 24.2 24.2 24.2 ...
 $ effective_date: POSIXct, format: "2008-01-01" "2008-01-01" ...
 $ report_date   : Date, format: "2010-03-01" "2010-03-01" ...
 - attr(*, ".internal.selfref")=<externalptr>



In [3]:

    
fs[, .N, report_date][order(report_date)]









    Out[3]:





report_date N

	1 2010-03-01 28080
	2 2010-05-01 28105
	3 2010-08-01 28104
	4 2011-02-01 26769
	5 2011-05-01 26812
	6 2011-08-01 26952
	7 2011-11-01 27005
	8 2012-02-01 27000
	9 2012-05-01 26988
	10 2012-08-01 26927
	11 2012-11-01 26920
	12 2013-03-01 26787
	13 2013-08-01 27130
	14 2013-11-01 27146
	15 2014-03-01 45997
	16 2014-06-01 45961
	17 2014-08-01 45973
	18 2014-11-01 46498
	19 2015-03-01 46171
	20 2015-05-01 46236
	21 2015-09-01 46732
	22 2015-12-01 46798
	23 2016-02-01 46903
	24 2016-04-01 46668



In [4]:

    
head(fs)
tail(fs)









    Out[4]:





procedure_code description modifier_1 modifier_2 rate_type price effective_date report_date

	1 00100 ANESTH, SALIVARY GLAND NA NA NA 24.19 2008-01-01 2010-03-01
	2 00102 ANESTH, REPAIR OF CLEFT LIP NA NA NA 24.19 2008-01-01 2010-03-01
	3 00103 ANESTH, BLEPHAROPLASTY NA NA NA 24.19 2008-01-01 2010-03-01
	4 00104 ANESTH, ELECTROSHOCK NA NA NA 24.19 2008-01-01 2010-03-01
	5 00120 ANESTH, EAR SURGERY NA NA NA 24.19 2008-01-01 2010-03-01
	6 00124 ANESTH, EAR EXAM NA NA NA 24.19 2008-01-01 2010-03-01









    Out[4]:





procedure_code description modifier_1 modifier_2 rate_type price effective_date report_date

	1 V5267 Hearing aid sup/access/dev NA NA NA 72.92 2009-01-01 2016-04-01
	2 V5274 Ald unspecified NA NA NA 115.16 2009-01-01 2016-04-01
	3 V5336 Repair communication device NA NA NA 780.61 2009-01-01 2016-04-01
	4 V5362 Speech screening NA NA NA 32.79 2009-01-01 2016-04-01
	5 V5363 Language screening NA NA NA 32.79 2009-01-01 2016-04-01
	6 V5364 Dysphagia screening NA NA NA 32.78 2009-01-01 2016-04-01

The December 2010 fee schedule throws an error. This can be fixed by using the dev version (1.9.7) of data.table, which adds a fill= argument to fread.



In [5]:

    
readFS(paste0(urlStem, "December%202010%20Fee%20Schedule%20-%20CSV.csv"))
readLines(paste0(urlStem, "December%202010%20Fee%20Schedule%20-%20CSV.csv"))[15169]









    



Error in fread(url, colClasses = "character", na.strings = c("")): Expecting 7 cols, but line 15169 contains text after processing all cols. It is very likely that this is due to one or more fields having embedded sep=',' and/or (unescaped) '\n' characters within unbalanced unescaped quotes. fread cannot handle such ambiguous cases and those lines may not have been read in as expected. Please read the section on quotes in ?fread.






    Out[5]:




"59151,TREAT ECTOPIC PREGNANCY,AS,,,$111.67 ,20100101,,,,,,,"

	report_date	N
1	2010-03-01	28080
2	2010-05-01	28105
3	2010-08-01	28104
4	2011-02-01	26769
5	2011-05-01	26812
6	2011-08-01	26952
7	2011-11-01	27005
8	2012-02-01	27000
9	2012-05-01	26988
10	2012-08-01	26927
11	2012-11-01	26920
12	2013-03-01	26787
13	2013-08-01	27130
14	2013-11-01	27146
15	2014-03-01	45997
16	2014-06-01	45961
17	2014-08-01	45973
18	2014-11-01	46498
19	2015-03-01	46171
20	2015-05-01	46236
21	2015-09-01	46732
22	2015-12-01	46798
23	2016-02-01	46903
24	2016-04-01	46668

	procedure_code	description	modifier_1	modifier_2	rate_type	price	effective_date	report_date
1	00100	ANESTH, SALIVARY GLAND	NA	NA	NA	24.19	2008-01-01	2010-03-01
2	00102	ANESTH, REPAIR OF CLEFT LIP	NA	NA	NA	24.19	2008-01-01	2010-03-01
3	00103	ANESTH, BLEPHAROPLASTY	NA	NA	NA	24.19	2008-01-01	2010-03-01
4	00104	ANESTH, ELECTROSHOCK	NA	NA	NA	24.19	2008-01-01	2010-03-01
5	00120	ANESTH, EAR SURGERY	NA	NA	NA	24.19	2008-01-01	2010-03-01
6	00124	ANESTH, EAR EXAM	NA	NA	NA	24.19	2008-01-01	2010-03-01

	procedure_code	description	modifier_1	modifier_2	rate_type	price	effective_date	report_date
1	V5267	Hearing aid sup/access/dev	NA	NA	NA	72.92	2009-01-01	2016-04-01
2	V5274	Ald unspecified	NA	NA	NA	115.16	2009-01-01	2016-04-01
3	V5336	Repair communication device	NA	NA	NA	780.61	2009-01-01	2016-04-01
4	V5362	Speech screening	NA	NA	NA	32.79	2009-01-01	2016-04-01
5	V5363	Language screening	NA	NA	NA	32.79	2009-01-01	2016-04-01
6	V5364	Dysphagia screening	NA	NA	NA	32.78	2009-01-01	2016-04-01