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MedicaidCoverageHigh impact

Provider Announcement

Oregon Health Plan·OR · Psychiatry·Provider
Effective date
Mar 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority (OHA) expanded Medicaid reimbursement for behavioral health skill reintegration services delivered via telemedicine, effective March 1, 2020. Four specific HCPCS codes (H0036, H0046, H2014, H2018) and one technology-based service code (G2012) are now billable for telemedicine delivery during the COVID-19 emergency. Providers must comply with the behavioral health fee schedule, Health Evidence Review Commission guidelines, and Oregon Administrative Rule 410-172-0850.

Action Required

Action needed
By March 1, 2020: Billing team must update billing system to enable telemedicine claim submission for codes H0036, H0046, H2014, H2018, and G2012 for Oregon Medicaid fee-for-service behavioral health claims. Ensure claims processing rules recognize these codes as billable via telemedicine. Providers must verify compliance with Oregon behavioral health fee schedule, Health Evidence Review Commission Ancillary Guideline Note A5, and OAR 410-172-0850 before submitting telemedicine claims. Document telemedicine delivery method on all claims. Claims submitted without proper telemedicine documentation or non-compliant with referenced guidelines will be denied. Contact dmap.providerservices@dhsoha.state.or.us or 800-336-6016 (Option 5) with questions.

Affected Billing Codes

H0036
H0046
H2014
H2018
G2012