House Bill 5202 (2022) includes a Special Purpose Appropriation by Committee recommendation for $42.5 million in state general funds for the Oregon Health Authority (OHA) to increase fee-for-service (FFS) and coordinated care organization (CCO) behavioral health provider rates by an average of 30 percent.
This investment is anticipated to result in approximately $154.5 million total funds for Oregon's Medicaid system.
FFS Rate Increases
In November 2022, the Centers for Medicare & Medicaid Services (CMS) approved broad increases to the FFS fee schedule. These increases are retroactively effective July 1, 2022, and increase provider rates by an average of 30 percent.
View the final rate increases (XLSX)
CCO Rate Increases
In January 2023, CMS approved OHA requiring and directing CCOs to significantly increase Medicaid behavioral health services reimbursement. Effective January 1, 2023, through December 31, 2023, the approved payment mechanism is called a “Directed Payment.” Approval of this payment mechanism is authorized through CMS regulation (42 CFR 438.6).
The following documents provide more information about Directed Payments: