MedicaidReimbursementMedium impact
Fee-for-service private duty nursing rates effective July 1, 2021
Oregon Health Plan·OR·Provider
Effective date
Jul 1, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Authority updated Medicaid fee-for-service rates for private duty nursing services effective July 1, 2021. RN rates increased to $65.10/hour and LPN rates to $40.55/hour for OHA services, with corresponding rate increases for ODHS services billed per 15-minute units.
Action Required
Immediately: Billing team must update fee schedules to use new rates for private duty nursing services with dates of service on or after July 1, 2021. For claims already submitted with old rates for services after July 1, 2021, coordinate with prior authorization processors to submit claim adjustments. Contact Provider Services at dmap.providerservices@dhsoha.state.or.us or 800-336-6016 (Option 5) with questions.