Fee-for-service nursing facility rates effective July 1, 2026

By June 30, 2026: Billing team must update all billing system software to implement new revenue codes and rates effective July 1, 2026. (1) Replace all Day 61+ routine home care billing from revenue code 651 to revenue code 650 in system rules. (2) Load new CBSA-specific per diem rates for all hospice services (codes 651, 650, 655, 656, 659, 652) into billing system, ensuring correct rates apply by geographic service area. (3) Load new nursing facility room and board bundled rates (codes 658, 194, 192, 199, 190) effective July 1, 2026. (4) Update claim submission requirements to mandate entry of nursing facility's Oregon Medicaid provider number in the 'Facility Number' field on all nursing facility claims. (5) Implement system logic to track hospice election dates and automatically apply correct revenue code (651 vs. 650) based on day count, accounting for readmissions within 60 days. (6) Update provider training materials to clarify revenue code 651 applies only Days 1-60 of hospice election; revenue code 650 applies Day 61 onward; and readmissions within 60 days restart the count using prior hospice days. (7) Create internal process to track and document registered nurse/social worker services provided in final 7 days of life for future service-intensity add-on (SIA) billing pending OHA guidance. Failure to implement changes will result in claim denials for incorrect revenue codes and missing provider numbers.