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HEDIS MY2026 IET
Oregon Peer Services Code Reference
A complete billing code reference for peer-led and community-based recovery organizations navigating Oregon Health Plan quality metrics — including H0038, the OHA-specific peer support code that is currently massively.
What is the IET measure — and why does it matter for peers?
Initiation and Engagement of SUD Treatment (IET) is a HEDIS quality measure used by Oregon CCOs to track whether members with a new substance use disorder diagnosis receive timely treatment.
The measure has two components: Initiation — a treatment service within 14 days of diagnosis — and Engagement — two or more additional services within 34 days of initiation.
H0038 (peer services, per 15 min) is on the IET value set as an OHA-specific addition. Every H0038 claim a peer-led organization files directly improves their CCO's IET score — and counts toward SHIP quality incentive metrics.
Compiled by Oregon Erratics LLC from NCQA HEDIS MY2026 value sets. Free to share under CC BY-NC-SA 4.0. Not legal or billing advice.
H0038
OHA-specific peer support code on IET value set
5,000+
Certified peers in Oregon — most not billing
14 days
Initiation window from index episode
$97+
Per-hour peer encounter value at OHP fee schedule
Complete IET MY2026 Code Reference
OREGON ERRATICS LLC
Medical Stewardship for Peer-Led Recovery Services™
HEDIS MY2026 — Initiation & Engagement of SUD Treatment (IET)
Oregon Peer Services Code Reference | March 2026 | Public Resource
HEDIS MY2026
Oregon Erratics
CC BY-NC-SA 4.0
About this document: Oregon Erratics compiled this reference from the NCQA HEDIS MY2026 value sets to support peer-led and community-based recovery organizations navigating Oregon Health Plan billing. H0038 (peer support services) is an OHA-specific addition highlighted throughout. Source: NCQA HEDIS MY2026; OHA peer services guidance. Not legal or billing advice.
What is the IET measure?
| Initiation (I) | First treatment service within 14 days of an index episode (new SUD diagnosis or SUD-related ED/inpatient visit). |
| Engagement (ET) | Two or more additional treatment services within 34 days of initiation — establishing ongoing engagement. |
| H0038 | Self-help/peer services, per 15 minutes (OHA-specific IET addition). Billable under Oregon Erratics medical director supervision. No COA required when billed as a Type 20 medical provider. |
Both components (I & ET) — CPT codes psychiatric · E&M · telephone · online
Psychiatric and therapy visits
90791907929083290833908349083690837908389083990840908459084790849908539087590876
Evaluation & management / office visits
99202992039920499205992119921299213992149921599242992439924499245993419934299344993459934799348993499935099381–9938799391–9939799401–9940499411994129948399492994939951099078
Telephone visits
9800898009980109801198012980139801498015989669896798968989799898098981994419944299443994579945899470
Online / asynchronous assessments
98016989709897198972994219942299423
Home health / community-based visits
9800098001980029800398004980059800698007989609896198962
Both components (I & ET) — HCPCS/H-codes: SUD services
SUD counseling, assessment & brief intervention
| H0001 | Alcohol and/or drug assessment |
| H0004 | Behavioral health counseling and therapy, per 15 minutes |
| H0005 | Alcohol/drug group counseling by a clinician |
| H0007 | Alcohol/drug crisis intervention (outpatient) |
| H0015 | Intensive outpatient (≥3 hrs/day, ≥3 days/week), including assessment and counseling |
| H0016 | Alcohol/drug services — medical/somatic (ambulatory) |
| H0022 | Alcohol/drug intervention service (planned facilitation) |
| H0034 | Medication training and support, per 15 minutes |
| H0047 | Alcohol/other drug abuse services, NOS |
| H0050 | Alcohol/drug brief intervention, per 15 min — contingency management anchor code |
| H2035 | Alcohol/other drug treatment program, per hour |
| H2036 | Alcohol/other drug treatment program, per diem |
| T1006 | Alcohol/SUD services — family/couple counseling |
| T1012 | Alcohol/SUD services — skills development |
SBIRT and structured screening
| G0396 | AUDIT/DAST structured assessment + brief intervention, 15–30 minutes |
| G0397 | AUDIT/DAST structured assessment + intervention, >30 minutes |
| G0443 | Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes |
| 99408 | Alcohol/SUD structured screening + brief intervention, 15–30 minutes |
| 99409 | Alcohol/SUD structured screening + intervention, >30 minutes |
Partial hospitalization / intensive outpatient
H0035H2001H2012G0410G0411S0201S9480S9484S9485
Both components (I & ET) — MOUD / medication-assisted treatment
Buprenorphine — oral, injectable, implant
| G2068 | Buprenorphine oral weekly bundle (OTP) |
| G2069 | Buprenorphine injectable monthly bundle (OTP) |
| G2070 | Buprenorphine implant insertion — weekly bundle |
| G2086 | Office-based OUD tx — ≥70 min, first month |
| G2087 | Office-based OUD tx — ≥60 min, subsequent months |
| H0033 | Oral medication administration, direct observation |
| J0571 | Buprenorphine oral, 1 mg |
| J0572–J0575 | Buprenorphine/naloxone oral (various strengths) |
| J0577–J0578 | Buprenorphine ER injectable (Brixadi) |
| Q9991–Q9992 | Buprenorphine ER injectable (Sublocade) |
| J0570 | Buprenorphine implant, 74.2 mg |
Methadone
| H0020 | Methadone administration/dispensing (OTP) |
| G2067 | Methadone weekly bundle (OTP) |
| G2078 | Take-home methadone, up to 7 additional days |
| S0109 | Methadone oral, 5 mg |
Naltrexone
| G2073 | Naltrexone weekly bundle (OTP) |
| J2315 | Naltrexone depot injection, 1 mg |
OUD weekly / non-drug bundles
G2074G2075G2076G2077G2079G2080G0533G2072
Both components (I & ET) — additional HCPCS/H codes
| H0002 | BH screening for treatment eligibility |
| H0031 | Mental health assessment by non-physician |
| H0036 | Community psychiatric supportive tx, per 15 min |
| H0037 | Community psychiatric supportive tx program, per diem |
| H0039 | Assertive community treatment, per 15 min |
| H0040 | Assertive community treatment program, per diem |
| H2000 | Comprehensive multidisciplinary evaluation |
| H2010 | Comprehensive medication services, per 15 min |
| H2011 | Crisis intervention service, per 15 min |
| H2013 | Psychiatric health facility service, per diem |
| H2014 | Skills training and development, per 15 min |
| H2015 | Comprehensive community support, per 15 min |
| H2016 | Comprehensive community support, per diem |
| H2017 | Psychosocial rehabilitation, per 15 min |
| H2018 | Psychosocial rehabilitation, per diem |
| H2019 | Therapeutic behavioral services, per 15 min |
| H2020 | Therapeutic behavioral services, per diem |
| T1015 | Clinic visit/encounter, all-inclusive |
| G0155 | Clinical social worker, home health, per 15 min |
| G0176 | Activity therapy (music, dance, art), ≥45 min |
| G0177 | Training/educational services, disabling MH, ≥45 min |
| G0409 | Social work/psychological services, CORF, per 15 min |
| G0463 | Hospital outpatient clinic visit |
| G0512 | Psychiatric collaborative care model, RHC/FQHC, per month |
| G0544 | Post-discharge telephonic follow-up, BH crisis, 4 calls/month |
| G0560 | Safety planning interventions, per 20 min |
| G2010 | Remote video evaluation (store and forward) |
| G2012 | Brief virtual check-in, 5–10 min |
| G2250 | Remote assessment, established patient |
| G2251 | Brief virtual check-in by qualified professional, 5–10 min |
| G2252 | Brief virtual check-in, 11–20 min |
| G0071 | RHC/FQHC virtual communication or remote evaluation, 5+ min |
Episode triggers — ICD-10-CM diagnosis codes (index event)
An IET measurement period is triggered when any of these diagnosis codes initiates an eligible encounter. The OE FHIR bridge is designed to pull these codes from existing Epic CareLink records to enable H0038 billing without requiring a new face-to-face visit.
Alcohol use disorders — F10.xx
F10.10F10.120F10.121F10.129F10.130F10.131F10.132F10.14F10.20F10.220F10.230F10.231F10.24F10.26F10.27F10.29
Opioid use disorders — F11.xx
F11.10F11.120F11.121F11.122F11.129F11.13F11.14F11.20F11.220F11.23F11.24F11.29
Cannabis — F12.xx
F12.10F12.120F12.13F12.20F12.220F12.23F12.29
Sedative/hypnotic/anxiolytic — F13.xx
F13.10F13.120F13.130F13.20F13.220F13.230F13.29
Cocaine — F14.xx · Stimulant — F15.xx
F14.10F14.20F14.13F14.23F15.10F15.20F15.13F15.23
Hallucinogen · Inhalant · Other — F16, F18, F19.xx
F16.10F16.20F18.10F18.20F19.10F19.20
Full subcategory codes included. See source CSV or PDF for all specifiers.
Substance abuse counseling (ICD-10-CM)
Z71.41Z71.51
Episode triggers — encounter codes (ED, detoxification)
ED encounters (CPT)
9928199282992839928499285
Detoxification (HCPCS)
H0008H0009H0010H0011H0012H0013H0014HZ2ZZZZ
Inpatient stay triggers use UBREV codes (01xx–02xx series). Hospice encounters are exclusions.
Exclusions — hospice (removed from denominator)
9937799378G0182G9473G9474G9475G9476G9477G9478G9479Q5003Q5004Q5005Q5006Q5007Q5008Q5010S9126T2042T2043T2044T2045T2046
Place of service codes (POS) — applicable outpatient settings
| POS | Description | POS | Description |
|---|---|---|---|
| 02 | Telehealth (other than home) | 03 | School |
| 10 | Telehealth in patient's home | 11 | Office |
| 12 | Home | 13 | Assisted Living Facility |
| 14 | Group Home | 15 | Mobile Unit |
| 17 | Walk-in Retail Health Clinic | 18 | Place of Employment / Worksite |
| 19 | Off-campus Outpatient Hospital | 20 | Urgent Care Facility |
| 22 | On-campus Outpatient Hospital | 27 | Outreach Site / Street |
| 33 | Custodial Care Facility | 49 | Independent Clinic |
| 50 | Federally Qualified Health Center | 71 | Public Health Clinic |
| 72 | Rural Health Clinic | 05 | Indian Health Service Free-standing Facility |
| 07 | Tribal 638 Free-standing Facility | 09 | Prison / Correctional Facility |
| 57 | Non-residential Substance Abuse Tx Facility | 58 | Non-residential Opioid Treatment Facility |
Download the full reference
Print-ready PDF with all codes, definitions, and page numbers