OHP Fee-for-Service Fee Schedule

Fee Schedule Files

The fee schedules are informational only. Because many factors influence payment, inclusion of a rate in the fee schedule does not guarantee payment. Rates may change without notice.

• Medical-Dental files reflect information available in the month posted, and do not reflect fees for all programs. Only codes with rate changes in the month posted will show a new effective date.
• Behavioral Health (Mental Health and Substance Use Disorder) fee schedules list the procedure codes and payment amounts effective for services provided on or after on and after the fee schedule date.

This list shows the most recent files available. Use the search function to view older files.

About Oregon Health Plan Rates and Fees

These apply only to services billed fee-for-service to the Oregon Health Authority (OHA). For services billed to coordinated care organizations (CCOs), contact the CCO to learn about their rates and fees.

Documents    2013 federal primary care codes and rates 2014 federal primary care codes and rates Fact Sheet: OHP Fee-For-Service Behavioral Health Fee Schedule Fee-for-service maximum allowable rates for medical and dental services Fee-for-service substance use disorder treatment rate increases, effective October 1, 2019 File specifications for FFS medical-dental fee schedule Oregon Medicaid Vaccines for Children administration codes and rates Oregon primary care providers and procedure codes

Compliance Details

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Other Resources

• For program-specific rates not listed in the OHP fee schedule and any program-specific payment policies that may apply: Refer to your provider guidelines, rules or contracts.
• For billing, service coverage, accepted codes and fee-for-service payment policies: See the OHP Billing Tips, General Rules, and OHP Administrative Rules.
• For prior authorization, procedure-specific coverage for an OHP client or benefit plan, or Prioritized List of Health Services coverage: Use the Benefits and HSC List Inquiry search on the secure Provider Web Portal.

Need Help?

• For reimbursement rates for services to OHP CCO members, contact the CCO.
• For questions about the rates listed on the fee schedule, contact Provider Services (800-336-6016).