MedicaidCoverageMedium impact
Notice of intent – OHA will amend the Medicaid State Plan, CHIP State Plan and Alternate Benefit Plan to add coverage for non-routine adult vaccinations - Comments due Oct. 13, 2023
Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +2 more·Public notice
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
Oregon Health Authority is expanding Medicaid coverage to include non-routine adult vaccinations (travel vaccines, occupational vaccines, etc.) effective October 1, 2023. This adds new billable services for Oregon Medicaid, CHIP, and Alternate Benefit Plan members who need vaccines based on age, health condition, occupation, or travel.
Action Required
By October 1, 2023: Billing teams in Oregon should verify their systems can bill for non-routine adult vaccines for Medicaid/OHP members. Update billing software to include travel and occupational vaccines as covered services. Use existing reimbursement methodology per Oregon Administrative Rule 410-120-1340 with RVU weights, NDC codes, or Average Sales Price. Verify eligibility for non-routine vaccines based on member's age, health conditions, occupation, or travel needs.