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Oregon Health PlanMedicaid · Billing Codes · Plan contract · OR · OB-GYNHigh impact

Billing guidance for obstetric services provided by FQHCs and RHCs

Effective date
Apr 21, 2026
Identified
Oct 6, 2026

Summary

Oregon Health Authority requires FQHCs and RHCs to bill specific obstetric visit codes (0500F, 0502F, 0503F) individually within global obstetric bundles starting April 21, 2026, to enable accurate encounter data matching and supplemental wraparound payment processing. CCOs must pay these codes at $0.00 and report them to OHA. Additionally, retroactive billing for dates of service October 1, 2024 through April 20, 2026 is permitted to resolve past payment discrepancies.

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What to do

Action · 7 steps
01Previously due April 21, 2026 (date passed; verify current applicability).
02Billing team must update billing system configuration to require use of codes 0500F, 0502F, or 0503F when billing CCOs for obstetric services provided on or after this date, reported individually within global/bundled codes 59400, 59425, 59426, 59410, and 59430.
03Configure system to set payment rate to $0.00 for these codes.
04Ensure codes are included in encounter data submitted to OHA for wraparound payment processing.
05For services provided October 1, 2024 through April 20, 2026 (retroactive period ending April 20, 2026).
06Billing team should identify any dates of service for which codes 0500F, 0502F, or 0503F were not previously billed and submit old claims to CCOs; note that CCOs are not required to accept retroactive claims.
07Without proper code billing and encounter reporting, OHA will not issue supplemental wraparound payments.

Codes mentioned

5940059425594265941059430

Original notice

Billing guidance for obstetric services provided by FQHCs and RHCs
oregon.gov no longer serves this document. We saved a copy on Nov 6, 2026.
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Related changes

See all Oregon Health Plan changes →
Billing guidance for obstetric services provided by FQHCs and RHCsMediumEffective Apr 21, 2026 · Plan contractSubmitting fee-for-service claims to receive the July 1, 2022 birth doula rate increaseMediumEffective Jul 1, 2022 · PlanBrowse every Oregon Health Plan change in the policy list

Related policy hubs

Oregon Health Plan policiesOR policy changesOB-GYNCode 59400Code 59425Code 59426Code 59410Code 59430

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