EOCCO Clinics and Staff,
Welcome to the November 2025 issue of the EOCCO monthly provider newsletter. Below is a preview of the articles you will find in this month’s newsletter:
News from EOCCO:
- Urine drug screening changes
- Changes to anesthesia reimbursement
- Thank you for attending EOCCO’s annual workshop
From our partners:
- Register now for Winter 2026 ECHO programs
- GOBHI’s Behavioral Health Navigator: Supporting a path to care
- New OHA-Certified/Qualified Health Care Interpreter (HCI) Registry file posted
- Oregon Clear Air at Home Program - Now Open!
- Unite Us: Connect Oregon Platform – join the network!
Please let us know if you have any questions, concerns or recommendations. We would love to hear from you!
Email us at: EOCCOproviderinquiry@modahealth.com
Thank you,
Your EOCCO Team
New from EOCCO:
Urine drug screening changes
Effective Dec. 1, 2025, EOCCO will require clinical chart notes for all definitive urine drug screening tests (G0480 & G0481). Each urine drug test administered to EOCCO members must meet Oregon Medicaid guidelines before a claim payment will be made. Clinical chart notes must also be received timely as outlined in the request. If clinical chart notes are not received timely then the claim will be denied.
As a reminder, EOCCO members have a benefit limit of 36 presumptive and 12 definitive tests per year. Each test must meet medical necessity. Please see the Oregon Health Plan guidelines below.
DIAGNOSTIC GUIDELINE D23, URINE DRUG TESTING
Urine drug testing (UDT) using presumptive testing is a covered diagnostic benefit when the results will affect treatment planning.
Definitive testing is covered as a confirmatory test only when the result of the presumptive testing is inconsistent with the patient’s history, presentation or current prescribed medication plan, and the results would change management.
Definitive testing other than to confirm the results of a presumptive test as specified above is not covered, unless the clinician suspects use of a substance that is inadequately detected by presumptive UDT (e.g., fentanyl). Definitive testing is limited to no more than 14 drug classes per date of service.
For patients receiving treatment for a substance use disorder, presumptive testing on up to 36 dates of service and definitive testing on up to 12 dates of service per year are covered. These limits must be applied in accordance with mental health parity law.
For patients receiving chronic opioid therapy for chronic pain, frequency of testing depends on the patient’s risk level (using a validated opioid risk assessment tool). Definitive testing should be conducted only for confirmatory purposes as described above and should not exceed 12 dates of service per year:
- Low risk: Random presumptive testing on up to two dates of service per year
- Moderate risk: Random presumptive testing on up to four dates of service per year
- High risk: Random presumptive testing on up to 12 dates of service per year
In patients with unexplained alteration of mental status and when knowledge of drug use is necessary for medical management (e.g., emergency department evaluation for altered mental status), UDT (presumptive and confirmatory definitive testing, if indicated) is covered in excess of the above limitations.
Urine drug testing conducted in accordance with policy of the DHS Office of Child Welfare Programs, when medically necessary, is also covered in excess of these limitations.
Changes to anesthesia reimbursement
Effective Jan. 1, 2026, EOCCO will no longer round up anesthesia time units when calculating reimbursement. Historically, the claims processing system rounded up anesthesia time units to the next whole number rather than using a proportion of time units. Going forward, providers will be reimbursed for the exact time that the anesthesia service was provided. If you have any questions, please contact eoccoproviderinquiry@modahealth.com.
Thank you for attending EOCCO’s annual workshop!
Thank you to all who attended EOCCO’s October and November workshops! With both in-person and virtual options, we had the highest number of registered participants to date. We look forward to seeing you again at next year’s event.
Each participant received a follow up survey and a copy of the workshop presentation slides. A PDF copy of the presentation slides is also available on the EOCCO provider news page.
If you have not yet completed the post-workshop survey, please click the 2025 post-workshop survey link. Your feedback is greatly appreciated and helps us improve future workshop content.
News from our partners:
Register now for winter 2026 ECHO Network programs
Registration is now open for winter 2026 Oregon ECHO Network programs. The Oregon Rural Practice-based Research Network (ORPRN) is excited to announce several never-before-offered programs:
- Social Needs
- Autism and ADHD in Adults
- Alzheimer's and Beyond: Advancing Dementia Care
- Substance Use Disorder Prevention and Early Intervention
ORPRN is also offering new cohorts of popular ECHO programs like Chronic Pain and Opioids, Pharmacological Weight Management, Palliative Care, and Pain Management and SUD in Dental Settings.
All of the interactive, virtual, case-based programs offered by the Oregon ECHO Network are always free and most offer no-cost continuing education credits. Please visit the Oregon ECHO Network website for more information and to register for these impactful professional development opportunities.
GOBHI’s Behavioral Health Navigator: Supporting a path to care
GOBHI is pleased to announce the addition of a behavioral health navigator—a role designed to improve coordination of care and help individuals access behavioral health services more easily.
The behavioral health navigator is here to:
- Help members connect to and schedule behavioral health appointments
- Serve as a direct contact for primary care providers and emergency departments to arrange behavioral health support for members in real time
This service strengthens timely access to care and supports individuals in navigating the behavioral health system with confidence.
Contact:
Sean Ross
Behavioral Health Navigator
Phone: 541-209-6488
Email: appointments@gobhi.org
Please visit GOBHI’s website to download the Behavioral Health Navigator flyer for more information.
New OHA-certified Health Care Interpreter Registry file posted
The October 2025 Oregon Health Authority Health Care Interpreter (HCI) Registry file has been posted to the EOCCO Incentive Measure webpage under “Meaningful Language Access”. This file contains a list of all active OHA certified or qualified health care interpreters in the state of Oregon. Files can be downloaded for your reference and records.
You can also search for OHA certified or qualified HCIs on the Health Care Interpreter Registry webpage.
Oregon Clean Air at Home program – now open!
The American Lung Association is now recruiting participants and referral partners for the Clean Air at Home program for low-income individuals living with chronic lung disease like asthma or COPD across the state of Oregon. Eligible participants will receive:
- One-on-one virtual home assessment with a lung health navigator to identify lung disease triggers
- FREE supplies or remediation services to improve indoor air quality in their home
- Resources for reducing indoor air pollution and managing their lung disease, including a personalized action plan
Agencies can either share this information with clients/patients or directly refer potential participants by filling out the interest form on the American Lung Association website. With questions about referring participants, please contact Alexis.Gigliello@lung.org.
Unite Us: Connect Oregon platform – join the network!
Unite Us: Connect Oregon is a community information exchange (CIE) tool that connects health and social service organizations through shared technology. Within the secure HIPAA-compliant web-based Unite Us platform, organizations can conduct social needs screenings, send and receive electronic referrals to address people’s social needs and ultimately help improve access to resources and services as well as improve health across communities.
EOCCO has been a Unite Us partner since 2022 and sponsors free platform licenses for providers across our network. There are some organization types including: FQHCs, RHCs, critical access hospitals, governmental agencies and 501c3 non-profits that qualify for free Unite Us licenses. If you are interested in becoming a part of this growing community network in Eastern Oregon (285 organizations strong!), please contact EOCCOmetrics@modahealth.com and we can help get you onboarded. Alternatively, you can fill out the Unite Us contact form to connect with a Unite Us representative.
Want to learn more about Unite Us and how it might support your organization and the clients you serve? See the informational resources below!
- What is Connect Oregon? Watch this video to learn more about how Connect Oregon coordinates health and social services to improve health across communities
- Unite Us: Connect Oregon. Visit the Unite Us website to learn more about how Connect Oregon’s network works.
- Learn more from the Oregon Health Leadership Council about the partnerships that support Connect Oregon.
Questions?
Questions related to incentive measures, health equity, traditional health workers, SDoH, and HIT - Please email EOCCOMetrics@modahealth.com
Questions related to claims and payment information - Please email EOCCOProviderInquiry@modahealth.com
Need to verify if your provider or group NPI is active? Please use OHA’s verification tool
Need to register your practitioner, group or facility? You can find forms on EOCCO.com/Providers/becomeaprovider
If you would like to be added or removed from the email list, please let us know at finn.gornick@modahealth.com
