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Effective January 1, 2023, the Oregon Health Authority (OHA) implemented a statewide rate increase for Medicaid Behavioral Health providers. As a CCO, we must increase our rates through four Behavioral Health Directed Payments (BHDPs) to improve equitable access to quality services for Columbia Pacific CCO enrollees through a more sustainable behavioral health workforce.
These BHDPs are:
You can find and access the correct updated fee schedule in our provider portal, CareOregon Connect.
We understand this impacts your operations and we are all anxious to make these changes. We appreciate your continued support and partnership as we work to ensure an efficient and effective implementation.
If you have questions or concerns, the online Provider Question Form is available.
Click on the arrow next to the sections below to see more information about what each behavioral health directed payment entails.
A uniform percent increase in reimbursement rates to qualified behavioral health participating/contracted providers. This increase is in addition to CCO contracted rates already in place effective in January 2022 and limited to the following covered services: Assertive Community Treatment (ACT), Supported Employment Services (SE), Outpatient Mental Health Treatment and Services (OP MH), and Outpatient and Non-inpatient withdrawal management Substance Use Disorder Treatment and Services (OP SUD). All rate increases received in 2022 will count towards the total 15% or 30% tiered increase effective January 1, 2023. This increase is in addition to any other ICD and/or CLSS QDP rate increases.
The increased percentage has two tiers based on the details of a provider’s total patient service revenue:
Qualified participating/contracted providers of:
All qualified non-contracted BH providers will be reimbursed at rates that are no less than OHA’s Medicaid Fee-for-Service (FFS) Behavioral Health Fee Schedule in effect on the date of service.
A uniform payment increase for qualified behavioral health providers certified by OHA for integrated treatment of Integrated Co-Occurring Disorders (ICD) rendered by qualified staff per OAR 309-019-0145. This increase is in addition to CCO contracted rates already in place effective January 2022 and any other tiered payment and/or CLSS QDP rate increases.
The following payment increases are available to qualified participating providers of:
A uniform payment increase to qualified behavioral health participating/contracted providers who deliver culturally and/or linguistically specific services (CLSS) as defined by the Oregon Administrative Rules (OARs). This increase is in addition to CCO contracted rates already in place effective January 2022 and any tiered payment and/or ICD QDP rate increases.
The following payment increases are available based on “Rural” and “Non-Rural” classifications:
For providers designated as follows by the OHA (per their online approved-provider list):
For providers designated as follows by the OHA (per their online approved-provider list):
Regardless of a provider’s contract status with a CCO, effective January 1, 2023, the Oregon Health Authority requires CCOs to reimburse qualified providers of Substance Use Disorders (SUD) Residential services, Applied Behavior Analysis (ABA) and Mental Health Children’s Wraparound services at rates that are no less than OHA’s Medicaid FFS Behavioral Health Fee Schedule in effect on the date of service.
Noncontracted providers may only be eligible for the “Minimum Fee Schedule Directed Payment.” Noncontracted providers do not qualify for the other BHDPs listed above and should not submit a Primarily Medicaid Provider Attestation form, nor a quarterly report related to CLSS or ICD reimbursement. Please review details for the Minimum Fee Schedule Directed Payment under the heading above to see if this applies to you.
You can find our Noncontracted MH and SUD fee schedule here.
For more information on how to contract with CareOregon, please review requirements and our submission form on our Provider Support page.
Columbia Pacific CCO appreciates and values our provider network for the care given to our members and community. We realize that this is a new and complex methodology. For questions, please submit your information to our team of experts.
The following documents provide more information about Directed Payments:
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