MedicaidCoverageMedium impact
NEMT for approved EPSDT services, effective January 1, 2023
Oregon Health Plan·OR · Pediatrics, Family Medicine·Provider
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority expanded EPSDT benefits for Medicaid members under age 21, effective January 1, 2023, to include all medically necessary services and non-emergent medical transportation (NEMT) to access these services. NEMT brokerages must approve exceptions to age limits and consider individual medical needs when determining transportation coverage.
Action Required
Immediately: For Oregon Medicaid patients under age 21, billing team should coordinate with NEMT brokerages to ensure transportation coverage includes all EPSDT services. Update patient scheduling processes to inform families that caregiver transportation may be covered regardless of age limits when medically necessary. Reference the EPSDT provider guide on OHA's Medical Transportation Services Program page for eligibility determinations.