MedicaidReimbursementHigh impact
Public notice - State Plan Amendment to increase Medicaid ventilator rate for nursing facilities
Oregon Health Plan·OR · Critical Care, Geriatrics·Public notice
Effective date
Mar 20, 2020
We identified it
Aug 19, 2026
Summary
Oregon Medicaid is increasing the Nursing Facility Ventilator Assisted Program (VAP) reimbursement rate from 200% to 235% of the basic nursing facility rate, effective retroactively to March 20, 2020. This rate increase applies to all nursing facilities billing Oregon Medicaid for ventilator-dependent patient care and requires claims adjustment for services rendered on or after the retroactive effective date.
Action Required
By March 31, 2020 (SPA submission deadline): Billing team must coordinate with nursing facility billing departments to recalculate VAP reimbursement rates retroactively from March 20, 2020. Update all billing systems and rate tables to apply the new 235% multiplier (previously 200%) to the basic nursing facility rate for VAP claims. Resubmit or adjust any claims for ventilator services billed between March 20-26, 2020 to reflect the increased rate. Notify facility management of the rate change and coordinate with accounts receivable to process retroactive adjustments. Failure to implement the new rate may result in underbilling and loss of revenue.