Behavioral Health

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

2023 Medicaid Behavioral Health Provider Directed Payment Increase

Trillium Behavioral Health Provider Credentialing Update for July 1, 2023    

Trillium Behavioral Health Provider Credentialing Update for July 1, 2023    

What is changing  

As of July 1, 2023, Trillium Community Health Plan (Trillium) will add Behavioral Health (BH) Board Registered Associates to the BH provider types that the CCO can enroll as a part of credentialing for BH group practices. 

As a CCO and partner with our BH provider network, Trillium values a whole-person approach to overall wellness and access to healthcare services for our members. That includes working with our BH provider network on strategies that support the best access to high quality and effective BH treatment services. In collaboration with our BH provider partners, we received feedback that adding BH associates registered with state clinical boards as allowed under the 410 OARs will enable improved access to BH services and support building the BH workforce of clinicians that serve Oregon Health Plan (OHP) members across our CCO regions. 

What is remaining the same

The following BH practitioner types require the below state clinical board license or OHA certification:

  • Credentialing Independent BH Practitioners: Individual BH practitioner credentialing requires an active license in good standing with a state clinical board in OR to practice independently without supervision.
  • Credentialing BH Practitioners certified through the Mental Health and Addictions Certification Board of Oregon (MHACBO): QMHPs, QMHAs, CADCs, CGACs and other BH practitioner types allowable under the 309 OARs require a provider/agency to hold a COA with OHA in order to enroll and credential these BH practitioner types. 

Where to send questions or updates to your Trillium BH roster template  

 

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.