Oregon Health Authority: Provider Matters (Oregon Health Plan provider bulletin) · June 26, 2026 · Primary source
Medicaid program updates: EPSDT, hospice services, substance use disorder Medicaid rates
Summary
The Oregon Health Authority issued a June 26, 2026 provider update covering three substantive areas: permanent adoption of OAR 410-151-0004 requiring OHP open card and CCO dental providers to use the OHP Dental Periodicity Schedule for EPSDT beneficiaries; updated fee-for-service nursing facility room and board rates for hospice services effective July 1, 2026 through June 30, 2027; and two SUD-specific updates, including federally mandated rate adjustments to certain codes in the July 1, 2026 Behavioral Health Fee Schedule and updated MAT billing guidance clarifying that eligible providers should bill for methadone medication when dispensing take-home doses. OARs 410-125-0045 and 410-125-0220 were also amended to allow Caring Contacts as a Medicaid-covered suicide prevention service.
What this may mean
SUD providers billing Oregon Medicaid must now use the newly updated code to capture methadone take-home dose dispensing in the July 1, 2026 Behavioral Health Fee Schedule, and are subject to federally mandated rate adjustments on certain codes effective the same date. The permanent EPSDT dental periodicity rule and the Caring Contacts coverage expansion create new billing opportunities and compliance obligations for dental and behavioral health providers serving OHP members.
Informational only. Not legal, medical, financial, or other professional advice. Always consult a qualified professional familiar with your specific facts before relying on any item.
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