MedicaidReimbursementLow impact
Fee-for-service reprocessing of outpatient claims planned for July 7, 2023
Oregon Health Plan·OR·Provider
Effective date
Jul 7, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority will reprocess all outpatient claims paid between January 1-February 6, 2023 on July 7, 2023 to apply updated Ambulatory Payment Classification (APC) pricing. Providers will see adjustment codes on remittance advices but no action is required.
Action Required
No action required. Monitor remittance advices for Detail EOB code 8008 on paper remits and Adjustment Reason Code 16 on ERAs/Provider Web Portal for affected claims from January 1-February 6, 2023 timeframe.