Back to dashboard
MedicaidReimbursementHigh impact

Fee-for-service rates for OHA/ODHS private during nursing services effective July 1, 2022

Oregon Health Plan·OR·Provider
Effective date
Jul 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority updated Medicaid fee-for-service rates for private duty nursing services effective July 1, 2022. New hourly rates range from $29.61 to $71.61 depending on provider type (RN vs LPN) and service category (OHA vs ODHS).

Action Required

Action needed
Immediately: Billing team must update rate tables in billing system to reflect new Medicaid private duty nursing rates effective July 1, 2022. For claims already submitted with service dates on or after July 1, 2022, coordinate with prior authorization processors to submit claim adjustments using the correct rates.

Affected Billing Codes

S9123
S9124
T1000
T1002
T1003
Fee-for-service rates for OHA/ODHS private during nursing services effective July 1, 2022 | Oregon Health Plan | PolicyChanges.app