Skip to Main Content

Behavioral Health

Thank you for your partnership in helping our members stay healthy!

2023 Medicaid Behavioral Health Provider Directed Payment Increase

What is the directed payment increase?

Effective January 1, 2023, the Oregon Health Authority (OHA) is implementing four behavioral health directed payments (BHDPs) within the CCO contracts that will further the goals and priorities of the Medicaid program. 

Trillium Medicaid Behavioral Health/Substance Abuse providers will receive a minimum of a 15% rate increase with possible additional increases based on the four health directed payments below:

  1. Tiered Uniform Rate Increase Directed Payment
  2. Co-Occurring Disorder Directed Payment
  3. CLSS Directed Payment
  4. Minimum Fee Schedule Directed Payment

What actions do I need to take?

How do I learn more?

Who can help me if I have questions?

Please contact your assigned Health Plan Provider Relations Representative. We are happy to help guide you through this process!

Prior Authorization Forms

Medicare

Medicaid

For behavioral health services only: Discharge information is required within 24 hours of discharge from IP or RTC levels of care. Please fax discharge clinicals to: 833-505-1300.

Note: Effective July 1, 2021, Prior Authorization requirements for some Behavioral Health (BH) codes have changed.

Codes described below will no longer require Prior Authorization for services when provided by a Participating Provider.  Non-Participating Providers still require a Prior Authorization for all services.

Prior Authorization requirements for all codes can be verified on our Pre-Auth Check Tool - Just visit https://www.trilliumohp.com/providers/preauth-check.html.

Behavioral Health Codes

Code Procedure PA Requirement / Units allowed prior to PA
90832, 90833, 90834, 90836 90837, 90838, 90846, 90847, 90849, 90853, H0004, H0005, H0006, H0036, T1006 Behavioral Health Outpatient Therapy  No Prior Authorization is required for Participating Providers.  Non-participating providers always require prior authorization.