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Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service rates for family planning services.
Effective date
Jul 1, 2026
Identified
Jun 20, 2026
Summary
Oregon Medicaid will increase the bundled family planning encounter rate (T1015) to $230 and establish a flat rate of $500 for vasectomy procedures (CPT 55250), replacing the current RVU-based reimbursement for vasectomies. These changes take effect July 1, 2026.
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What to do
Action · 2 steps
01Before July 1, 2026: Billing team must update fee schedules in billing system to reflect new Oregon Medicaid rates - T1015 family planning encounters at $230 and CPT 55250 vasectomies at flat rate of $500.
02Update any internal rate cards and train staff on the vasectomy billing change from RVU-based to flat rate payment.
Codes mentioned
T101555250
Original notice
Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service rates for family planning services.
oregon.gov · Always check the source before changing claims.