MedicaidCoverageMedium impact
Fee-for-service billing criteria for immunization counseling, effective Jan. 1, 2026
Oregon Health Plan·OR · Dentistry·Provider
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Summary
Oregon Health Authority will reimburse dental code D1301 for immunization counseling starting January 1, 2026, but only when immunizations are not administered the same day. Dental providers must register with ALERT IIS system and verify patients need vaccines before billing.
Action Required
By January 1, 2026: Dental billing team must register with Oregon's ALERT Immunization Information System as query users to check patient vaccination status. Update billing software to prevent D1301 billing on same date as vaccine administration. Train providers on required documentation standards - generic templates are not sufficient for reimbursement.