MedicaidCoverageMedium impact
OHP coverage of hMPXV (human monkeypox virus) vaccines and testing
Oregon Health Plan·OR · Family Medicine, Internal Medicine, Pediatrics +2 more·Plan
Effective date
Jul 26, 2022
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) now covers human monkeypox virus (hMPXV) vaccines, testing, and treatment effective July 26, 2022. Providers can bill specific CPT codes for vaccine administration and lab testing without prior authorization for all OHP members.
Action Required
Immediately: Billing team must update system to allow billing of CPT codes 87593 (hMPXV lab test), 90471 (vaccine administration without counseling), and 90460 (vaccine administration with counseling for patients 18 and under) for Oregon Health Plan members without prior authorization. Note: Bill only for vaccine administration, not the vaccine serum itself as it's provided free through Strategic National Stockpile.