MedicaidReimbursementMedium impact
Provider Announcement
Oregon Health Plan·OR · Psychiatry·Plan
Effective date
Apr 30, 2020
We identified it
Jun 20, 2026
Summary
The Oregon Health Authority posted an erroneous behavioral health fee schedule for three days (April 28-30, 2020) that contained unintended reductions. The correct May 2020 Behavioral Health Fee Schedule was uploaded on April 30, 2020. CCOs and providers must honor the May 2020 rates retroactively for the April 28-30 period, and MMIS is configured to reimburse at May 2020 rates going forward. Fee-for-service providers should continue billing normally.
Action Required
By May 7, 2020: Billing team must verify that all claims submitted during April 28-30, 2020 for behavioral health services are reprocessed to reflect May 2020 fee schedule rates instead of the erroneous posted rates. Verify MMIS system is configured to apply May 2020 rates. Contact OHA Provider Services at 800-336-6016 or dmap.providerservices@dhsoha.state.or.us if any claims were underpaid during the three-day error period to request adjustments. For CCO-covered services, contact your specific CCO to ensure retroactive rate corrections are applied. Fee-for-service providers should continue billing normally without system changes. Failure to reconcile may result in underpayment for claims processed during the error window.