MedicaidAdministrativeMedium impact
Provider Announcement
Oregon Health Plan·OR · Psychiatry, Palliative Care·Provider
Effective date
Jan 15, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Authority clarifies retainer payment policies for residential behavioral health settings. Providers can request retainer payments for temporary absences only (within 2 business days, with completed form), cannot bill retainer payments for evicted residents, and must avoid duplicate billing of retainer payments (T2033) and residential care payments (T1020) on the same date. Duplicate claims will be flagged for recoupment.
Action Required
Immediately: Billing team must implement controls in billing system to prevent duplicate claims when both T2033 (Retainer Payment) and T1020 (Residential Payment for Personal Care) are billed on the same date of service—OHA will recoup duplicate claims through retrospective review. Update claim submission procedures to ensure retainer payment requests are submitted within 2 business days of absence with completed Retainer Payment Form via MMIS Provider Portal (for Medicaid members) or ABH.ResidentialCapacityReporting@dhsoha.state.or.us (for non-Medicaid members). Stop submitting retainer payment requests for residents who have received eviction notices. Providers submitting non-Medicaid requests must include prior authorization numbers and detailed information with each submission.