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MedicaidReimbursementMedium impact

Fee-for-service rates for DHS-OHA private duty nursing services effective January 1, 2020

Oregon Health Plan·OR·Provider
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority increased Medicaid fee-for-service rates for private duty nursing services effective January 1, 2020. RN rates increased to $62.00/hour and LPN/LVN rates to $38.62/hour for OHA services, with corresponding rate increases for DHS services billed in 15-minute units.

Action Required

Action needed
Immediately: Billing team must update billing systems to use new rates for private duty nursing services with dates of service January 1, 2020 and after. Contact DHS to update service authorizations to reflect rate increases. Submit adjusted claims to DHS/OHA for any 2020 claims already submitted at old rates. Contact Kelly.Jamison@dhsoha.state.or.us with questions.

Affected Billing Codes

S9123
S9124
T1000
T1002
T1003