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Oregon Health PlanMedicaid · Coverage · Provider · OR · Psychiatry, Palliative CareHigh impact

Change to interRAI Community Mental Health (CMH) assessment tool effective July 31, 2026

Act
by Jul 31, 2026
Effective date
Jul 31, 2026
Identified
Jul 11, 2026

Summary

Oregon Health Authority is replacing the Level of Service Inventory (LSI) assessment tool with the interRAI Community Mental Health (CMH) instrument for determining 1915(i) HCBS program eligibility effective July 31, 2026. This change affects service eligibility determination and residential rate calculations. The LSI will continue for Young Adults in Transition (YAT) Homes serving individuals under 21.

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What to do

by Jul 31, 2026 · 8 steps
01Billing and clinical teams must transition from LSI to interRAI CMH assessment tool for all 1915(i) HCBS program eligibility determinations.
02Clinical staff: Review OHA's new Assessment Process Guide and implement interRAI CMH scoring for functional intensity measures and person-centered service planning.
03Billing team: Update rate calculations to align with interRAI CMH scores rather than LSI scores; verify that billing software reflects new assessment instrument in rate determination logic.
04All staff: Ensure care team member interviews and observations inform assessments per new process.
05Establish process for submitting reconsiderations to IQA (Comagine Health) per updated guidelines.
06Exception: Continue using LSI for YAT Home residents under 21 years old.
07Failure to implement interRAI CMH by effective date will result in incorrect eligibility determinations and rate calculations.
08Contact Comagine Health (ORBHSupport@comagine.org) or OHA 1915(i) HCBS Policy team (1915i.MedicaidPolicy@odhsoha.oregon.gov) for implementation support.

Original notice

Change to interRAI Community Mental Health (CMH) assessment tool effective July 31, 2026
oregon.gov · Always check the source before changing claims.
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Oregon Health Plan policiesOR policy changesPsychiatryPalliative Care

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