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MedicaidCoverageMedium impact

Fee-for-service reimbursement for self-administered COVID-19 test kits supplied by non-pharmacy providers, effective April 4, 2022

Oregon Health Plan·OR·Plan
Effective date
Apr 4, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority now allows non-pharmacy providers (including clinics, hospitals, and physicians) to bill for FDA-approved COVID-19 home test kits supplied to fee-for-service Medicaid members. Coverage is up to 8 tests per month at $12 per test without prior authorization, effective April 4, 2022.

Action Required

Action needed
Immediately: Oregon Medicaid providers can begin billing HCPCS code K1034 for COVID-19 home test kits supplied to FFS members. Use revenue code 0300 for institutional claims. Bill one unit per test (two units if package contains two tests). Adjust any previously submitted claims using the Claim Adjustment Handbook procedures.

Affected Billing Codes

K1034