MedicaidCoverageMedium impact
CCOF coverage of dental services in facility settings
Oregon Health Plan·OR · Dentistry, Oral & Maxillofacial Surgery·Plan
Effective date
Jan 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is implementing a new CCOF plan type effective January 1, 2023, for dental-only benefits including COFA Dental and Veteran Dental Program members. CCOs must reimburse for covered dental services delivered in ambulatory surgical centers, inpatient or outpatient hospital settings, while OHA will handle facility fees.
Action Required
By January 1, 2023: Billing team must prepare systems to administer CCOF benefit for dental services in facility settings. Update billing workflows to coordinate with OHA for facility payment while billing CCOs directly for dental services only. Ensure proper plan type identification for COFA Dental and Veteran Dental Program members to route claims correctly.