Oregon Health Authority: Tools for OHP Health Plans (coordinated care organization announcements) · April 29, 2026 · Primary source
Rate increases for family planning visits and vasectomies effective July 1, 2026.
Summary
The Oregon Health Authority issued a Medicaid Division policy memorandum dated April 29, 2026, announcing fee-for-service rate increases for two family planning codes effective July 1, 2026. The all-inclusive family planning clinic visit code T1015 increases from $185 to $230, and CPT code 55250 for vasectomy increases to $500 for both facility and non-facility settings. The increases apply to Oregon Health Plan providers, family planning clinics, and coordinated care organizations, with CCOs directed to review claims processing systems and contracts.
What this may mean
Oregon Medicaid fee-for-service rates for HCPCS T1015 and CPT 55250 increase effective July 1, 2026, for enrolled family planning clinics and OHP providers. CCOs must update claims processing systems and contracts to reflect the new rates for services rendered on or after that date. Use of T1015 remains limited to enrolled family planning clinics under Oregon Administrative Rule 410-130-0587.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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