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Rate increases for family planning visits and vasectomies effective July 1, 2026.
Act
by Jul 1, 2026
Effective date
Jul 1, 2026
Identified
Jun 20, 2026
Summary
Oregon Health Authority is increasing reimbursement rates for family planning services effective July 1, 2026. HCPCS code T1015 (family planning clinic visits) will increase from $185 to $230, and CPT code 55250 (vasectomy) will increase to $500 for both facility and non-facility rates.
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What to do
by Jul 1, 2026 · 3 steps
01Billing team must update fee schedules in billing system to reflect new rates - T1015 increases to $230 and CPT 55250 increases to $500.
02CCOs must review claims processing systems and contracts for necessary changes.
03Begin billing at increased rates for services performed on or after July 1, 2026.
Codes mentioned
T101555250
Original notice
Rate increases for family planning visits and vasectomies effective July 1, 2026.
oregon.gov · Always check the source before changing claims.
Related changes
See all Oregon Health Plan changes →Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service rates for family planning services.MediumEffective Jul 1, 2026 · Public noticeFee-for-service rate increase for family planning visits effective July 1, 2024MediumEffective Jul 1, 2024 · PlanBrowse every Oregon Health Plan change in the policy list