MedicaidPrior AuthMedium impact
Handicapping malocclusion codes and rates effective Jan. 1, 2025
Oregon Health Plan·OR · Dentistry, Oral & Maxillofacial Surgery·Provider
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) has added new handicapping malocclusion orthodontic benefit codes with specific fee-for-service rates effective January 1, 2025. Prior authorization is required for comprehensive orthodontic treatment codes, and providers must follow new HM Benefit Guidance for eligible EPSDT members.
Action Required
Immediately for Oregon providers: Update billing system with new orthodontic fee schedule rates for handicapping malocclusion treatment. Ensure prior authorization is obtained for codes D8070, D8080, D8090, and D8091 before treatment. Follow OHA's HM Benefit Guidance for patient eligibility verification. Contact Provider Services at 800-336-6016 for questions.