Oregon Office of Rural Health

Oregon Office of Rural Health

2026 billing changes for OB services at FQHCs and RHCs

Billing Guidance for Obstetric Services Provided by FQHCs and RHCs

Starting April 21, 2026, Oregon Health Authority (OHA) requires Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to use the following codes to report individual obstetric (OB) visits when billing CCOs:

  • 0500F - Initial prenatal care visit
  • 0502F - Subsequent prenatal care
  • 0503F - Postpartum care visit

This applies to visits provided on or after Oct. 1, 2024, under the following global or bundled procedure codes.

  • 59400 - Obstetrical care (antepartum, delivery, and postpartum care)
  • 59425 - Antepartum care, 4-6 visits
  • 59426 - Antepartum care, 7 or more visits
  • 59410 - Obstetrical care (delivery and postpartum only)
  • 59430 - Care after delivery (postpartum only)

Why is this happening?
Before issuing supplemental wraparound payments, OHA must ensure that CCO encounter data matches the encounters reported by the FQHC/RHC for wraparound. Any discrepancies will prevent payment. This change will ensure OHA can issue timely supplemental wraparound payments.

For services provided on or after April 21, 2026:

  • Providers: When billing CCOs for obstetric care, use the new codes to report individual obstetric visits contained within the global and bundled codes.
  • CCOs: Pay the new codes at $0.00. Include them in the encounter data submitted to OHA.

This process will ensure that OHA has the data needed to issue supplemental wraparound payments.

For services provided on or after Oct. 1, 2024, through April 20, 2026, OHA has determined that it is necessary for some providers to bill CCOs for 0500F, 0502F or 0503F for past dates of service in order for OHA to issue supplemental wraparound payments. However, OHA cannot require CCOs to accept old claims.

  • Providers: Bill codes 0500F, 0502F or 0503F to CCOs for any date(s) of service for which this code has not already been billed.
  • CCOs: To the greatest extent possible, accept old claims from FQHCs/RHCs for 0500F, 0502F or 0503F and pay them at $0.00. Include them in the encounter data submitted to OHA.

Email Adrienne Cooke with any questions or call 503-551-0630.