MedicaidBilling CodesMedium impact
Clarification on mental health billing for peer-delivered services
Oregon Health Plan·OR · Psychiatry·Provider
Effective date
Oct 29, 2025
We identified it
Jun 20, 2026
Summary
Oregon Health Authority updated the Behavioral Health Peer-Delivered Services Billing Guide to remove specific diagnosis codes from procedure codes and reference the Behavioral Health Services Subset of the Prioritized List instead. This clarifies that peer providers can bill for both mental health and substance use disorder diagnoses.
Action Required
Immediately: Billing teams for behavioral health peer-delivered services must stop using the specific diagnosis codes previously listed with procedure codes. Instead, reference the Behavioral Health Services Subset of the Prioritized List of Health Services for appropriate diagnosis codes. Update billing software and encounter forms to reflect that peers can bill for both mental health and substance use disorder diagnoses.