MedicaidReimbursementMedium impact
Notice of intent – OHA will amend the Medicaid State Plan to revise inpatient hospital psychiatric reimbursement for Oregon DRG hospitals.
Oregon Health Plan·OR · Psychiatry·Public notice
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is implementing a new tiered MS-DRG payment structure for inpatient psychiatric services at DRG hospitals, with separate adult and pediatric base rates that vary by hospital. The new methodology will be rebased every two years with annual Medicare market basket updates.
Action Required
By January 7, 2025: Oregon hospitals should review the proposed State Plan Amendment and submit written comments to jesse.anderson@oha.oregon.gov if they have concerns about the new psychiatric reimbursement methodology. Billing teams at Oregon DRG hospitals should prepare for the new tiered MS-DRG payment structure for psychiatric services starting January 1, 2025, which will use separate adult and pediatric unit values for MDC-19 and MDC-20 cases.