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Fee-for-service rate increase for neonatal and pediatric intensive care professional services
Act
immediately
Effective date
Jan 1, 2022
Identified
Jun 20, 2026
Summary
Oregon Health Authority is increasing reimbursement rates for neonatal and pediatric intensive care services (CPT codes 99468-99480) effective January 1, 2022, but providers must temporarily stop billing these codes until the system updates are complete.
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What to do
immediately · 3 steps
01Stop billing CPT codes 99468-99480 for neonatal and pediatric intensive care services until OHA completes MMIS system updates.
02Monitor for notification from OHA when billing can resume.
03For 2022 claims already submitted with these codes, await guidance on reprocessing to apply the rate increase.
Codes mentioned
99468994699947099471994729947399474994759947699477994789947999480
Original notice
Fee-for-service rate increase for neonatal and pediatric intensive care professional services
oregon.gov · Always check the source before changing claims.
Related changes
See all Oregon Health Plan changes →Fee-for-service reprocessing of neonatal and pediatric intensive care service professional claims planned for week of September 12, 2022LowEffective Sep 13, 2022 · ProviderOHP coverage of home blood pressure monitoring services during the COVID-19 emergencyLowEffective Sep 3, 2020 · PlanOHP coverage of home blood pressure monitoring services during the COVID-19 emergencyMediumEffective Sep 3, 2020 · PlanNotice of intent: OHA will amend the Medicaid State Plan to increase the rate for two newborn procedure codes.MediumEffective Oct 1, 2025 · Public noticeBrowse every Oregon Health Plan change in the policy list