MedicaidCoverageHigh impact
Provider Announcement
Oregon Health Plan·OR · Psychiatry·Plan
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Authority expanded telehealth coverage for behavioral health services during COVID-19, including telephone services (CPT 99441-99443, 98966-98968) and adding GT modifier to six HCPCS codes. Coverage is retroactive to January 1, 2020. Billing teams must update systems to recognize these codes and modifiers for Oregon Medicaid fee-for-service claims.
Action Required
By March 31, 2020: Billing team must update Oregon Medicaid billing system to: (1) Enable reimbursement for CPT codes 99441-99443 and 98966-98968 for telephone services when conditions are met; (2) Add GT modifier to codes H0004, H0005, H0006, H0015, T1006, and 90849 for telehealth behavioral health services; (3) Update claim scrubbers to allow these codes without prior authorization; (4) Ensure encounter forms document service delivery method (telehealth vs. telephone) and verify claims meet the 7-day lookback and 24-hour forward restrictions. Billing team should also reprocess or rebill eligible claims from January 1, 2020 forward. Failure to implement will result in claim denials for telehealth/telephone behavioral health services.