MedicaidCoverageMedium impact
Change to coverage of COVID-19 home test kits effective March 1, 2026
Oregon Health Plan·OR·Plan contract
Effective date
Mar 1, 2026
We identified it
Jun 20, 2026
Summary
Effective March 1, 2026, Oregon Health Plan (OHP) coverage of COVID-19 home test kits will decrease from 8 kits per member per month to 4 kits per member per month. No prior authorization or PCP order is required. Additionally, COVID-19 home test kits will no longer qualify as an In Lieu of Service, superseding previous guidance from February 2022.
Action Required
By February 28, 2026: Billing team must update systems and documentation to reflect the reduced allowance of 4 COVID-19 home test kits per member per month (down from 8). Remove any existing rules or encounter form language indicating that COVID-19 home test kits qualify as an In Lieu of Service. Coordinate with providers to ensure they understand no prior authorization is needed but that the quantity limit has decreased. Claims submitted for more than 4 kits per member per month will be denied or subject to member cost-sharing effective March 1, 2026.