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MedicaidReimbursementMedium impact

Notice of intent – OHA will amend the Medicaid State Plan to increase fee-for-service primary care rates.

Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +1 more·Public notice
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority is increasing Medicaid fee-for-service primary care rates by 2%, raising the conversion factor from $27.82 to $28.50. This affects evaluation and management codes, immunization administration codes, and health/behavior assessment codes.

Action Required

Action needed
Monitor for final approval and implementation date: Once effective, billing team should verify that billing system automatically applies the new conversion factor ($28.50) for Oregon Medicaid claims using the listed primary care codes. No manual updates needed if system uses current fee schedules.

Affected Billing Codes

90460
90471
90472
90473
90474
96150
96151
96152
96153
96154
96155
96160
96161
99201
99202
99203
99204
99205
99211
99212
99213
99214
99215
99217
99218
99219
99220
99221
99222
99223
99224
99225
99226
99231
99232
99233
99234
99235
99236
99238
99239
99281
99282
99283
99284
99285
99291
99292
99304
99305
99306
99307
99308
99309
99310
99315
99316
99318
99324
99325
99326
99327
99328
99334
99335
99336
99337
99339
99340
99341
99342
99343
99344
99345
99347
99348
99349
99350
99354
99355
99356
99357
99360
99363
99374
99375
99377
99378
99379
99380
99381
99382
99383
99384
99385
99386
99387
99391
99392
99393
99394
99395
99396
99397
99401
99402
99403
99404
99406
99407
99408
99409
99411
99412
99441
99442
99443
99460
99461
99462
99463
99464
99465
99487
99489
99490
99495
99496
99497
99498
G0396
G0397
G0442
G0443
G2011