Dental Incentives Available in 2025 through the OHP, Pending CMS Approval

Starting in 2025, the Oregon Health Plan (OHP), Oregon’s Medicaid program, plans to roll out a set of Incentive Payments for dental providers, pending CMS approval. 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 addition 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 exists 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.