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MedicaidReimbursementLow impact

Fee-for-service reprocessing of neonatal and pediatric intensive care service professional claims planned for week of September 12, 2022

Oregon Health Plan·OR · Pediatrics, Critical Care·Provider
Effective date
Sep 13, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority will automatically reprocess and increase payments for neonatal and pediatric intensive care claims (CPT codes 99468-99480) paid between January 1 and August 30, 2022. Providers will see adjustment codes on remittance advices starting September 13, 2022, but no action is required.

Action Required

Action needed
No action required. Billing team should be aware that remittance advices starting September 13, 2022 will show pricing adjustments for neonatal and pediatric intensive care claims with codes 9920 (paper) or 45 (electronic). These are positive adjustments increasing previous payments.

Affected Billing Codes

99468
99469
99470
99471
99472
99473
99474
99475
99476
99477
99478
99479
99480