MedicaidCoverageMedium impact
Billing for diabetes self-management and prevention programs
Oregon Health Plan·OR · Family Medicine, Internal Medicine, Endocrinology +1 more·Plan
Effective date
Aug 25, 2022
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) covers diabetes self-management and prevention programs for members with Type I/II diabetes and prediabetes. The policy encourages providers to refer eligible OHP members to these covered programs and provides resources for finding local programs and billing requirements.
Action Required
Immediately: Providers should begin referring OHP members with diabetes or prediabetes to covered self-management programs. Contact local public health departments or search Oregon's Healthy Living programs list to find available programs. Review OHA's fact sheets about reimbursement requirements for billing these services. For billing questions, contact Provider Services at 800-336-6016 for fee-for-service or the member's CCO for managed care members.