Behavioral Health Qualified Directed Payment (QDP/BHDPs) overview
Effective January 1, 2023, the Oregon Health Authority (OHA) implemented a statewide rate increase for Medicaid Behavioral Health providers. As a partner with Health Share of Oregon CCO, we must increase our rates through four Behavioral Health Directed Payments (BHDPs) to improve equitable access to quality services for CareOregon/Health Share enrollees through a more sustainable behavioral health workforce.
These BHDPs are:
- Tiered Uniform Rate Increase Directed Payment
- Integrated Co-occurring Disorder (ICD) Directed Payment
- Culturally & Linguistically Specific Services (CLSS) Directed Payment
- Minimum Fee Schedule Directed Payment
Click on the arrow next to the sections below to see more information about what each behavioral health directed payment entails.
Tiered Uniform Rate Increase Directed Payment
A uniform percent increase in reimbursement rates to qualified behavioral health participating/contracted providers. This increase is in addition to CCO contracted rates already in place effective in January 2022 and limited to the following covered services: Assertive Community Treatment (ACT), Supported Employment Services (SE), Outpatient Mental Health Treatment and Services (OP MH), and Outpatient and Non-inpatient withdrawal management Substance Use Disorder Treatment and Services (OP SUD). The increased percentage has two tiers based on the details of a provider’s total patient service revenue:
- Tier 2 “Primarily Medicaid” – defined as having at least 50% of its total patient service revenue derived from providing Medicaid services in the prior calendar year.
- Tier 1 “Primarily Non-Medicaid” – defined as having less than 50% of its total patient service revenue from providing Medicaid services in the prior calendar year.
How Do Providers Get Paid the Increased Rate?
- All qualified participating providers who held a contract on or after January 1, 2022, will automatically receive the Tier 1 “Primarily Non-Medicaid” rate increases incorporated into the CareOregon Fee Schedule. If a qualified participating provider meets criteria for the Tier 2 “Primarily Medicaid” rate increase, the provider must provide documentation demonstrating criteria is met based on the BH revenue from Medicaid services provided in the previous calendar year.
- Fill out the OHA’s Primarily Medicaid Provider Attestation form, available on the Oregon.gov website. Completed forms are to be submitted through a secure email to CareOregon at BH_attest@careoregon.org.
Noncontracted providers
Noncontracted providers do not qualify for the other BHDPs listed above and should not submit a Primarily Medicaid Provider Attestation form, nor a quarterly report related to CLSS or ICD reimbursement. Please review details for the Minimum Fee Schedule Directed Payment under the heading above to see if this applies to you.
You can find our Noncontracted BH & SUD fee schedule here, or on our Metro BH provider page.
For more information on how to contract with CareOregon, please review requirements and our submission form on our Provider Support page.
Questions or additional support? Please contact your Provider Relations Specialist at MetroBHPRS@careoregon.org
Provider Updates & FAQs
The following documents provide more information about Directed Payments:
Forms & Additional Resources
- Primarily Medicaid Provider Attestation is provided by the OHA and is available on the Oregon.gov website
- Completed Primarily Medicaid Provider Attestation forms and supporting documentation must be submitted through a secure email to CareOregon at: BH_attest@careoregon.org.
