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Dental Incentives Available in 2025 Through the OHP

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Pending CMS Approval, starting in 2025, the Oregon Health Plan (OHP), Oregon’s Medicaid program, plans to roll out a set of Direct Payment Incentives for dental providers. The incentives will reward for preventative care and increasing access for Medicaid members. The following two options will be available in 2025:

  • Preventative and Minimally Invasive Bundle: If a provider completes a set of preventive services for a Medicaid member in six months, an additional payment of $30 for a pediatric member and $50 for adult member will be paid on top of normal reimbursement for those services.
  • Provider Incentive: Two incentive structures will exist for new providers (less than 25 members served in recent past) and existing providers (more than 25 members served). The bonuses range from $3,500 to $15,000 for dental providers depending on their service volume and members served.

OHA will host webinars this fall/winter on these incentives. Please watch for more details in the coming months! If you have questions or feedback, please contact OHA at Actuarial.Services@odhsoha.oregon.gov.

 

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