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MedicaidCoverageMedium impact

Updates about COVID and flu vaccines for CCO members under age 19

Oregon Health Plan·OR · Family Medicine, Pediatrics, Internal Medicine·Plan contract
Effective date
Jan 1, 2025
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2025, Oregon Medicaid (CCO) members under age 19 can now receive COVID and flu vaccines from pharmacies not enrolled in the Vaccines for Children (VFC) program, and these pharmacies will be reimbursed by Medicaid. This change is federally mandated and continues through December 31, 2029.

Action Required

Action needed
Immediately: Billing team must ensure claims processing system is configured to accept and pay claims from non-VFC pharmacies for COVID and flu vaccines administered to Oregon CCO members under age 19. Verify vaccine administration codes are processing correctly for this expanded provider network. Inform providers that non-VFC pharmacies are now eligible for reimbursement for these specific vaccines.