Medicaid Behavioral Health Directed Payments
Updated: January 2024
Medicaid raises reimbursement for Oregon BH providers
Behavioral health providers contracted with PacificSource Community Solutions in Oregon as of January 1, 2022, received an increase in 2023. Providers saw a minimum increase of 15% over 2022 rates, with a further 15% increase for those who worked primarily with Medicaid clients.
Four BH Directed Payments:
15% rate increase—automatic
If your reimbursements from PacificSource are based on the OHA behavioral health fee schedule, this 15% increase will be automatic. If your reimbursements aren't based on the OHA fee schedule, we'll reach out to you.
30% increase—“primarily Medicaid” providers
If more than half of your practice’s revenue comes from Medicaid, you are eligible for an additional 15% increase (beyond the 15% base) for qualifying services.
To initiate review for the 30% increase:
- Download and complete the Attestation Form (XLS) confirming you work primarily with Medicaid clients.
- Email the completed form to PNORC@PacificSource.com.
2. Co‐Occurring Disorders (COD)
Information is available on the OHA website.
3. Cultural and Linguistic Specific Services (CLSS)
Information is available on the OHA website.
4. Minimum Fee Schedule
For 2023, the Oregon Health Authority (OHA) has implemented a directed payment arrangement that requires CCOs to maintain the fee schedule for SUD Residential, Applied Behavior Analysis, and MH Children’s Wraparound services at no lower than the OHA State Plan Medicaid Behavioral Health Fee-For-Service fee schedule rate in effect at the date of service.
As of January 1, 2023, PacificSource Community Solutions CCOs are in compliance with this requirement.
We’re here to help
Contact the Provider Network Oregon Contracting team: PNORC@PacificSource.com