CPT 99464, in plain terms, covers Physician attendance at a delivery, requested by the delivering clinician, to perform initial stabilization of the newborn. CPT 99464 is referenced in 2 tracked payer policy changes from Oregon Health Plan. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 99464 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Official descriptor: CPT 99464 on AAPC
Oregon Medicaid is increasing reimbursement rates for newborn procedure codes 99464 and 99465 to match the higher conversion factor of $38.76 that was previously applied to other neonatal intensive care codes. This corrects an oversight from a previous rate increase.
Oregon Health Authority is increasing Medicaid fee-for-service primary care rates by 2%, raising the conversion factor from $27.82 to $28.50. This affects evaluation and management codes, immunization administration codes, and health/behavior assessment codes.
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