Or. Rev. Stat. » Oregon Revised Statutes

Or. Rev. Stat. § 742.525

Provider charges

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      742.525 Provider charges. (1) Except as provided in subsection (2) of this section, a provider shall charge a person who receives personal injury protection benefits or that person’s insurer the lesser of:

      (a) An amount that does not exceed the amount the provider charges the general public; or

      (b) An amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.248 for expenses of medical, hospital, dental, surgical and prosthetic services.

      (2) For expenses of hospital services that are subject to the adjusted cost-to-charge ratio specified for a hospital in the hospital fee schedule published pursuant to ORS 656.248, a provider of hospital services shall charge a person who receives personal injury protection benefits or that person’s insurer the greater of:

      (a) The amount of the hospital charges multiplied by the adjusted cost-to-charge ratio specified for the hospital; or

      (b) Ninety percent of the hospital charges. [2003 c.813 §4; 2005 c.341 §4; 2011 c.707 §1]

Notes of Decisions
Cited in 7 cases (2 in the last 5 years), 2009–2024 · leading case: Dowell v. Oregon Mutual Insurance Co.
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Dowell v. Oregon Mutual Insurance Co. (2017) or · cites it 4× “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
Strawn v. Farmers Insurance (2009) orctapp “” By the time the court entered that judgment, ORS 742.525 had been enacted. Or Laws 2003, ch 813, § 4.”
Geico Indemnity Co. v. Virtual Imaging Services, Inc. (2011) fladistctapp “Or.Rev.Stat. § 742.525 (2004). . Section 627.”
Geico General Insurance v. Virtual Imaging Services, Inc. (2012) fladistctapp “Or.Rev.Stat. § 742.525 (2004). . Section 627.”
Koenig v. State Farm Mutual Automobile Ins. Co. (2021) orctapp · cites it 2× “And, if bills are disputed on the ground that they may not be causally related to the accident, the PIP insurer is in peril of owing the insured attorney fees if those expenses are later shown to be so related.”
State v. Roskelley (2024) orctapp “See ORS 742.525(1)(b) (providing that PIP claimants shall be charged “an amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.”
Dowell v. Oregon Mutual Ins. Co. (2017) or · cites it 2× “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
— Or. Rev. Stat. § 742.525(1)(b) — 4 cases
Dowell v. Oregon Mutual Insurance Co. (2017) or “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
Koenig v. State Farm Mutual Automobile Ins. Co. (2021) orctapp “And, if bills are disputed on the ground that they may not be causally related to the accident, the PIP insurer is in peril of owing the insured attorney fees if those expenses are later shown to be so related.”
State v. Roskelley (2024) orctapp “See ORS 742.525(1)(b) (providing that PIP claimants shall be charged “an amount that does not exceed the fee schedules for medical services published pursuant to ORS 656.”
Dowell v. Oregon Mutual Ins. Co. (2017) or “, ORS 742.525, ORS 742.528. An insurer may deny a PIP claim for medical expenses; however, the “potential existence of a cause of action in tort does not relieve an insurer from the duty to pay [PIP] benefits.”
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