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Notice of intent: OHA will amend the Medicaid State Plan to increase the rate for two newborn procedure codes.
Effective date
Oct 1, 2025
Identified
Jun 20, 2026
Summary
Oregon Medicaid is increasing reimbursement rates for newborn procedure codes 99464 and 99465 to match the higher conversion factor of $38.76 that was previously applied to other neonatal intensive care codes. This corrects an oversight from a previous rate increase.
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What to do
Action · 2 steps
01Monitor for State Plan Amendment approval: Once CMS approves this amendment (expected mid-2025), billing team should verify that Oregon Medicaid claims for CPT codes 99464 and 99465 are reimbursing at the increased rate of $38.76 conversion factor.
02No immediate action required as this is currently in public comment period until January 10, 2025.
Codes mentioned
9946499465
Original notice
Notice of intent: OHA will amend the Medicaid State Plan to increase the rate for two newborn procedure codes.
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 primary care rates.MediumNo effective date · Public noticeFee-for-service rate increase for neonatal and pediatric intensive care professional servicesHighEffective Jan 1, 2022 · ProviderBrowse every Oregon Health Plan change in the policy list