MedicaidReimbursementMedium impact
Request for comment - State Plan Amendment to increase TCM home visiting rate - Comments due November 1, 2019
Oregon Health Plan·OR · OB-GYN, Pediatrics, Family Medicine·Public notice
Effective date
Nov 1, 2019
We identified it
Jun 20, 2026
Summary
Oregon Medicaid is increasing fee-for-service reimbursement rates by 29% for Targeted Case Management Maternal and Child Health home visiting programs (Babies First!, CaCoon, Family Connects®, and Nurse Family Partnership®) effective November 1, 2019. The rate is being rebased from 2012 costs to 2019 costs and is billed using treatment code T1017.
Action Required
By November 1, 2019: Billing team must update rate tables in billing system to reflect the 29% increase in reimbursement for TCM home visiting services billed under code T1017. Verify that all claims for Babies First!, CaCoon, Family Connects®, and Nurse Family Partnership® programs submitted on or after November 1, 2019 use the new increased rates. Contact Jesse Anderson (jesse.anderson@dhsoha.state.or.us or 503-947-1119) with any billing questions. Claims submitted with outdated rates may be subject to adjustment or denial.