MedicaidReimbursementMedium impact
Fee-for-service rate increases for Medicaid planned community birth providers
Oregon Health Plan·OR · OB-GYN·Plan
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is implementing significant rate increases for Medicaid planned community birth providers, with some rates increasing over 400%. Licensed direct entry midwives and standalone birth centers should update billing systems and either adjust previously submitted claims or wait for OHA to reprocess them.
Action Required
By March 31, 2024: Providers must update billing systems with new rates from the Medical-Dental Fee Schedule once published. For claims submitted since July 1, 2023, either adjust claims for timely reimbursement or wait 3-4 weeks for OHA to reprocess automatically. CCOs must add newborn facility fee (99460) effective March 1, 2024 and update payment systems to match OHA fee-for-service rates.