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
Aug 19, 2026
Summary
Oregon Health Authority is proposing a 29% increase in fee-for-service reimbursement rates for Targeted Case Management (TCM) Maternal and Child Health home visiting programs (Babies First!, CaCoon, Family Connects®, Nurse Family Partnership®) effective November 1, 2019. The rate will be rebased from 2012 costs to 2019 costs and billed using treatment code T1017. This is a public comment period ending November 1, 2019.
Action Required
By November 1, 2019 at 5 p.m.: If your practice participates in Oregon Medicaid TCM home visiting programs (Babies First!, CaCoon, Family Connects®, Nurse Family Partnership®), submit written comments to jesse.anderson@dhsoha.state.or.us (fax 503-947-1119) regarding the proposed 29% rate increase. After effective date (November 1, 2019): Update billing team fee schedules in the billing system for T1017 treatment code to reflect the increased reimbursement rates when OHA issues final guidance. Notify clinical staff that billing rates for these maternal/child health home visiting programs will increase. Monitor for official rate documentation from OHA to ensure accurate billing implementation.