MedicaidReimbursementHigh impact
Fee-for-service rate increase for neonatal and pediatric intensive care professional services
Oregon Health Plan·OR · Pediatrics, Critical Care·Provider
Effective date
Jan 1, 2022
We identified it
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.
Action Required
Immediately: Stop billing CPT codes 99468-99480 for neonatal and pediatric intensive care services until OHA completes MMIS system updates. Monitor for notification from OHA when billing can resume. For 2022 claims already submitted with these codes, await guidance on reprocessing to apply the rate increase.