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MedicaidBilling CodesMedium impact

SUD treatment code and rate changes effective January 1, 2022

Oregon Health Plan·OR · Psychiatry·Plan contract
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority will implement fee-for-service reimbursement for substance use disorder (SUD) treatment in facilities with more than 16 beds and community integration services. New CPT and HCPCS codes are being added with updated reimbursement rates, including care coordination, case management, residential treatment, methadone administration, and supported housing/employment services.

Action Required

Action needed
By January 1, 2022: Oregon providers must update billing systems with new SUD treatment codes and rates. Billing team should verify final code list and rates on OHA's behavioral health fee schedule before January 1, 2022. CCOs must update provider contracts to include SUD 1115 demonstration waiver codes for reimbursement.

Affected Billing Codes

G9012
H0006
H0018
H0019
H0020
H0022
H0023
H0039
H0043
H0050
H2010
H2011
H2014
H2023
H2032
H2036
Q3014
T1016