Behavioral Health Updates

Effective January 1, 2026

WHAT IS CHANGING

Oregon’s behavioral health system continues to face high demand and evolving needs. To better support this landscape, Oregon Health Authority (OHA) has refined its Behavioral Health Directed Payment (BHDP) policy for Calendar Year 2026 (CY26).

The tiered payment structures (“Primarily Medicaid” and “Primarily Non-Medicaid”) have been removed and OHA has replaced the criteria which redirects the directed payments to providers who qualify as Team-Based High Acuity Medicaid Providers.

 

WHO QUALIFIES FOR ENHANCED PAYMENTS IN 2026

To qualify in 2026, a provider must either:

A. Be a Community Mental Health Program offering: Assertive Community Treatment (ACT), Early Assessment and Support Alliance (EASA), or Intensive In-Home Behavioral Health Treatment (IIBHT)

OR

B. Meet all of the following:

1. Hold a Certificate of Approval from OHA.

2. Derive ≥50% of BH service revenue from OHP members.

· Provider is responsible for submission of annual attestation that must be submitted with the previous year’s financial summary. The attestation and YE Financials must be submitted to Advanced Health no later than January 31st of following year. See Resources below for link to the attestation form.

3. Deliver integrated, team-based care including (as clinically indicated):

  •  On-staff or contracted psychiatric or addiction medicine provider
  • Integrated peer support
  • Case management services

 

What is staying the same?

CLSS and COD Directed Payments: OHA made no changes to the CLSS or COD behavioral health directed payments. If you are an OHA approved CLSS or COD provider, please continue to follow OHA’s billing requirements in order to receive the directed payment.

Resources:

For more information, please review OHA’s webpage about the Behavioral Health Rate Increase for Medicaid Providers.

For direct assistance please contact Kera Hood – kera.hood@advancedhealth.com