MedicaidReimbursementHigh impact
2025 fee-for-service rates for handicapping malocclusion services
Oregon Health Plan·OR · Dentistry·Plan contract
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority added five new billing codes to the handicapping malocclusion treatment benefit and updated fee-for-service rates for all orthodontic codes, effective January 1, 2025. Prior authorization is now required for comprehensive orthodontic treatment codes D8070, D8080, D8090, and D8091.
Action Required
Immediately: Billing team must update system with new 2025 fee-for-service rates for handicapping malocclusion codes. Configure prior authorization requirements for codes D8070, D8080, D8090, and D8091. Update billing software to use lump sum payment model consistent with Oregon Administrative Rule 410-123-1260. Process all CCO claims using the new rates and PA requirements to qualify for risk corridor coverage.