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Oregon Health PlanMedicaid · Billing Codes · Provider · OR · Psychiatry, General PracticeHigh impact

Clarification about billing for S0109 (Methadone, 5 mg) effective July 1, 2025

Act
by Jun 30, 2025
Effective date
Jul 1, 2025
Identified
Jun 26, 2026

Summary

Oregon Medicaid clarifies that SUD providers can bill for methadone medication (S0109) AND administration (H0020) for all doses, including take-home doses, effective July 1, 2025. This expands billing to cover take-home methadone doses previously unclear in guidance, requiring providers to bill both the medication and administration codes to properly track distribution.

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What to do

by Jun 30, 2025 · 4 steps
01Billing team must update billing software to bill S0109 (methadone, 5 mg) AND H0020 (methadone administration) together for ALL methadone doses, including take-home doses dispensed on or after July 1, 2025.
02Update provider documentation and training materials to clarify that both codes must be billed together.
03Review current claim submission workflows to ensure take-home dose claims are not being rejected or underbilled.
04Contact the SUD Medicaid team at sud.waiver@oha.oregon.gov if claims are previously denied for this billing combination.
If missed: Failure to bill both codes will result in incomplete tracking of methadone distribution and potential revenue loss.

Codes mentioned

S0109H0020

Original notice

Clarification about billing for S0109 (Methadone, 5 mg) effective July 1, 2025
oregon.gov · Always check the source before changing claims.
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Related changes

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Related policy hubs

Oregon Health Plan policiesOR policy changesPsychiatryGeneral PracticeCode S0109Code H0020

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