MedicaidBilling CodesHigh impact
Clarification about billing for S0109 (Methadone, 5 mg) effective July 1, 2025
Oregon Health Plan·OR · Psychiatry, General Practice·Provider
Effective date
Jul 1, 2025
We identified it
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.
Action Required
By June 30, 2025: Billing 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. Update provider documentation and training materials to clarify that both codes must be billed together. Review current claim submission workflows to ensure take-home dose claims are not being rejected or underbilled. Contact the SUD Medicaid team at sud.waiver@oha.oregon.gov if claims are previously denied for this billing combination. Failure to bill both codes will result in incomplete tracking of methadone distribution and potential revenue loss.