MedicaidBilling CodesMedium impact
Request for Comment - Draft Medicaid State Plan Amendment to Align MH and SUD Services - Comments due Feb. 21, 2020
Oregon Health Plan·OR · Psychiatry, Internal Medicine, Family Medicine·Public notice
We identified it
Jun 20, 2026
Summary
Oregon's Health Authority is proposing a Medicaid State Plan Amendment to expand Substance Use Disorder (SUD) treatment services by aligning coverage with mental health services, including residential treatment facilities, recovery support services, and transitional housing. New CPT/HCPCS codes will be added to the Medicaid fee schedule for SUD providers, requiring billing system updates once codes are finalized.
Action Required
By February 21, 2020: Medical billing team should monitor for follow-up notices from Oregon Health Authority specifying the exact CPT/HCPCS codes to be added to the SUD fee schedule. Once codes are published (expected after CMS approves the State Plan Amendment), billing team must: (1) Update billing software to recognize new SUD service codes; (2) Configure claim submission rules for SUD services under Medicaid; (3) Train providers and front-desk staff on new billable services including residential treatment, recovery support services, and transitional housing support. Failure to implement code updates timely will result in claim denials for SUD services provided by Oregon Medicaid enrollees. This is a public comment period; additional notification will follow once final codes are determined.