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Fee-for-service nursing facility rates effective July 1, 2026
Act
by Jun 30, 2026
Effective date
Jul 1, 2026
Identified
Jun 26, 2026
Summary
Oregon Health Authority updated fee-for-service hospice payment rates effective July 1, 2026, including new nursing facility room and board bundled rates and revised revenue codes for routine home care billing. Revenue code 650 (Days 61+) replaces previous coding for extended hospice stays, and providers must include the nursing facility's Oregon Medicaid provider number on all claims. Rates vary by geographic Cost-Based Statistical Area (CBSA).
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What to do
by Jun 30, 2026 · 8 steps
01Billing team must update all billing system software to implement new revenue codes and rates effective July 1, 2026.
02Replace all Day 61+ routine home care billing from revenue code 651 to revenue code 650 in system rules.
03Load 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.
04Load new nursing facility room and board bundled rates (codes 658, 194, 192, 199, 190) effective July 1, 2026.
05Update claim submission requirements to mandate entry of nursing facility's Oregon Medicaid provider number in the 'Facility Number' field on all nursing facility claims.
06Implement 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.
07Update 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.
08Create 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.
If missed: Failure to implement changes will result in claim denials for incorrect revenue codes and missing provider numbers.
Original notice
Fee-for-service nursing facility rates effective July 1, 2026
oregon.gov · Always check the source before changing claims.
Related changes
See all Oregon Health Plan changes →Fee-for-service hospice NF rates effective July 1, 2020 – June 30, 2021LowEffective Jul 1, 2020 · ProviderFee-for-service hospice rates effective April 1, 2020 through June 30, 2020LowEffective Apr 1, 2020 · ProviderFee-for-service hospice NF rates effective July 1, 2020 – June 30, 2021LowEffective Jul 1, 2020 · ProviderFee-for-Service Hospice Rates Effective Oct. 1, 2026HighEffective Oct 1, 2026 · ProviderBrowse every Oregon Health Plan change in the policy list