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Oregon Health PlanMedicaid · Coverage · Provider · OR · DentistryMedium impact

Fee-for-service billing criteria for immunization counseling, effective Jan. 1, 2026

Act
by Jan 1, 2026
Effective date
Jan 1, 2026
Identified
Jun 20, 2026

Summary

Oregon Health Authority will reimburse dental code D1301 for immunization counseling starting January 1, 2026, but only when immunizations are not administered the same day. Dental providers must register with ALERT IIS system and verify patients need vaccines before billing.

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What to do

by Jan 1, 2026 · 3 steps
01Dental billing team must register with Oregon's ALERT Immunization Information System as query users to check patient vaccination status.
02Update billing software to prevent D1301 billing on same date as vaccine administration.
03Train providers on required documentation standards - generic templates are not sufficient for reimbursement.

Codes mentioned

D1301

Original notice

Fee-for-service billing criteria for immunization counseling, effective Jan. 1, 2026
oregon.gov · Always check the source before changing claims.
View original ↗

Related policy hubs

Oregon Health Plan policiesOR policy changesDentistryCode D1301

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