MedicaidReimbursementMedium impact
Payment recovery planned for fee-for-service IMD residential per diem claims
Oregon Health Plan·OR · Psychiatry·Provider
Effective date
Mar 21, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is recovering overpayments for substance use disorder residential treatment claims (codes H0018 and H0019) from July 1, 2022 through March 20, 2023 due to incorrect rate calculations. Updated per diem rates are now in effect with specific amounts for different program types.
Action Required
No immediate action required. Monitor remittance advice for adjustment ICNs beginning with '52' and Net Overpayment amounts. Review EOB 8400 codes indicating account receivables that will be deducted from future payments. Contact Provider Services at dmap.providerservices@oha.oregon.gov if questions arise about overpayment recovery.