MedicaidCoverageMedium impact
Guidance on how to fund respite services
Oregon Health Plan·OR · Pediatrics, Psychiatry, Family Medicine·Plan
Effective date
May 1, 2024
We identified it
Jun 20, 2026
Summary
Oregon Health Authority issued guidance for CCOs on funding respite services for children and youth with complex needs. Four existing Medicaid billing codes (H0045, T1005, S5150, S9125) can be used for respite care billing, and CCOs are encouraged to develop or enhance coverage through Health Related Services and SHARE initiative funding mechanisms.
Action Required
Immediately: Billing teams in Oregon should verify their systems can process respite care codes H0045, T1005, S5150, and S9125 for Medicaid CCO patients. Contact CCO representatives to understand coverage policies for respite services and available funding mechanisms. Update encounter forms to include respite care options for pediatric patients with complex needs.