Oregon Medicaid Changes: What the New Rules Mean for Mental Health Coverage

For many individuals and families, Medicaid is the only way to access consistent mental health care. In Oregon, thousands of people rely on this coverage for therapy, psychiatric services, and essential support. But in 2025, new policy changes are reshaping how Medicaid works in the state—and it’s leaving many people wondering what it means for their care.

If you or a loved one depends on Medicaid Oregon, understanding these changes is key to protecting your access to therapy and knowing what options are available moving forward.

What changes are happening with Oregon Medicaid mental health coverage in 2025?

In 2025, Medicaid Oregon is tightening its rules around provider participation and reimbursement rates for mental health services. The most significant changes include:

• Stricter requirements for therapists to remain in-network

   

• New limits on out-of-network coverage for mental health treatment

   

• Adjusted reimbursement structures that are encouraging more providers to join group practices instead of working independently

   

For patients, this could mean fewer independent therapists accepting Medicaid Oregon, but potentially more access to larger clinics and community mental health organizations. While the state aims to improve coordination of care, the transition may feel disruptive for those already established with a trusted provider.

Does Oregon Medicaid still cover out-of-network therapy?

One of the most common questions patients are asking is whether Medicaid Oregon will still cover therapy with an out-of-network provider. The short answer: in most cases, no.

Previously, some exceptions allowed patients to continue seeing their therapist even if that provider wasn’t officially in-network, especially if they lived in rural areas with limited access. Starting in 2025, those exceptions are narrowing significantly. Coverage will typically only be granted for out-of-network care when no in-network provider is reasonably available.

This means patients may need to transition to an in-network therapist or group practice if their current provider no longer accepts Medicaid Oregon.

How can I find a therapist who accepts Oregon Medicaid?

If you’re searching for a therapist under Medicaid Oregon, here are some steps that can help:

1. Check the official provider directory on the Oregon Health Authority or your Coordinated Care Organization’s website.

    

2. Call local clinics and group practices directly—many are onboarding more therapists to meet new Medicaid requirements.

    

3. Ask your current therapist for referrals within the Medicaid system if they’re no longer able to accept your insurance.

    

4. Explore telehealth options, as many therapists licensed in Oregon can provide care virtually and still bill Medicaid Oregon.
   

While it may take persistence, being proactive ensures you don’t face a gap in coverage or support.

Why are more therapists moving into group practices under Oregon Medicaid?

With the 2025 changes, many independent therapists are finding it difficult to continue working solo under Medicaid Oregon. 

Lower reimbursement rates, more administrative demands, and strict compliance rules are pushing providers to join group practices, clinics, or larger mental health organizations.

Group practices make it easier to share resources, manage billing, and meet Medicaid’s updated requirements. For patients, this can sometimes mean shorter wait times or access to a broader range of services in one place. However, it also reduces the flexibility of working with an independent therapist, which some clients prefer for personalized care.

What are my options if my therapist no longer takes Oregon Medicaid?

If your current therapist is leaving Medicaid Oregon, it doesn’t mean your therapy journey has to end. Here are a few options to consider:

• Transition to an in-network provider through your Coordinated Care Organization.

   

• Ask about continuity of care provisions, which may allow you to see your current therapist for a limited time during the switch.

   

• Explore sliding-scale or reduced-fee services if you want to continue with your current provider outside of Medicaid coverage.

   

• Look into community mental health centers, which often accept Medicaid Oregon and provide comprehensive services.

   

The most important step is to be proactive—don’t wait until your next appointment to ask about your provider’s Medicaid status. Early planning gives you more choices and a smoother transition.

Final Thoughts

The 2025 updates to Medicaid Oregon are designed to streamline services and expand access through larger networks of providers.

But for many individuals, the changes may feel confusing or even disruptive, especially if it means switching therapists.

If you’re currently receiving care, check in with your provider now to confirm whether they’ll remain in-network under Medicaid Oregon. Some group practices, including Abri Psychotherapy, will continue to accept OHP, so you may still be able to stay with your current therapist.

And if you’re just beginning your therapy journey, know that there are still many qualified therapists ready to support you—you may just need to adjust where you look. Mental health care should always be accessible, and while these changes may bring challenges, they also create opportunities for more coordinated, long-term support under the Medicaid Oregon system.