MedicaidAdministrativeMedium impact
Billing for Peer-Delivered Services Update
Oregon Health Plan·OR · Psychiatry, General Practice, Family Medicine·Plan contract
We identified it
Aug 19, 2026
Summary
Oregon Medicaid (OHA) is pausing final billing guidance for peer-delivered services in non-COA settings (primary care, hospitals, clinics). The agency will convene workgroups in Summer 2025 to develop clarity on peer billing pathways and roles, with final guidance expected by September 2025. Billing teams should anticipate changes to peer service billing procedures but should not implement changes until official guidance is released.
Action Required
By September 2025: Billing team must monitor oregon.gov/oha/HSD for final peer-delivered services billing guidance and policy updates. Do NOT implement peer billing changes until official guidance is published. If your practice bills for peer-delivered services (Traditional Health Workers or peer support specialists) in primary care or other non-behavioral health settings, designate a staff member to review the September 2025 guidance and update billing workflows, encounter forms, and staff training accordingly. Failure to implement correct billing procedures after guidance release may result in claim denials. To stay informed or provide input, contact Rusha.Grinstead@oha.oregon.gov to join the workgroup.