MedicaidAdministrativeMedium impact
Claim formats for CCO-contracted Out-of-Hospital Birth services providers
Oregon Health Plan·OR · OB-GYN·Plan contract
Effective date
Feb 18, 2026
We identified it
Jun 20, 2026
Summary
Oregon CCOs that have signed the Out-of-Hospital Birth opt-in amendment can now accept claims from contracted OOHB providers using either professional (CMS-1500/837P) or institutional (UB-04/837I) claim formats. This change allows more accurate billing for multi-day episodes of care including labor, delivery, and postpartum observation.
Action Required
Immediately: CCOs with OOHB opt-in amendments must work with contracted Out-of-Hospital Birth providers to ensure they can submit claims using either professional (CMS-1500/837P) or institutional (UB-04/837I) formats. Billing teams should update claim processing systems to accept both formats from OOHB providers and train staff on processing institutional claims for these services.