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.
Minimum Fee Schedule Directed Payment
Regardless of a provider’s contract status with a CCO, effective January 1, 2023, the Oregon Health Authority requires CCOs to reimburse qualified providers of Substance Use Disorders (SUD) Residential services, Applied Behavior Analysis (ABA) and Mental Health Children’s Wraparound services at rates that are no less than OHA’s Medicaid FFS Behavioral Health Fee Schedule in effect on the date of service.
Which Providers Qualify?
- The directed payment is limited to Medicaid covered SUD Residential, Applied Behavior Analysis, and MH Children’s Wraparound services.
How Do Providers Get Paid?
- All qualified providers will receive payment no less than OHA’s Medicaid FFS Behavioral Health Fee Schedule in effect on the date of service.
CareOregon's Noncontracted Fee Schedule
You may review CareOregon's Noncontracted MH & SUD metro BH fee schedule on our Metro Behavioral Health webpage.
Noncontracted providers
Noncontracted providers may only be eligible for the “Minimum Fee Schedule Directed Payment.” 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.
