MedicaidCoverageHigh impact
Medicaid Coverage of Crisis Respite Services and Respite Care
Oregon Health Plan·OR · Psychiatry·Provider
Effective date
Jan 11, 2022
We identified it
Jun 20, 2026
Summary
Oregon Medicaid has clarified that Crisis Respite Services (procedure code H0045) can only be billed by Residential Treatment Facilities (RTFs) and Secure Residential Treatment Facilities (SRTFs). Adult Foster Homes (AFHs) are not eligible to bill for Crisis Respite Services and must refer these cases to licensed RTFs/SRTFs instead.
Action Required
Immediately: Billing teams at Adult Foster Homes must stop billing procedure code H0045 for Crisis Respite Services. Withdraw all pending Crisis Respite Services requests submitted to Comagine Health. For current AFH residents approved for Crisis Respite Services, submit requests to Comagine Health for 1915(i) HCBS assessment and service planning. Only bill for standard Respite Care services and refer Crisis Respite cases to OHA-licensed RTFs/SRTFs.