MedicaidCoverageHigh impact
OHP coverage of post-COVID (sometimes called “long COVID”) treatment
Oregon Health Plan·OR·Plan
Effective date
Mar 14, 2022
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) CCOs must now cover all medically appropriate post-COVID/long COVID treatments, including services normally below the funding line or not covered. CCOs must establish medical necessity determination processes and begin adjudicating claims according to this guidance by March 14, 2022.
Action Required
By March 14, 2022: Billing teams must establish processes for post-COVID treatment claims that require medical necessity determinations. Update billing system to recognize that condition/treatment pairings below funding line with ICD-10 U09.9 as secondary diagnosis are covered without additional review. Contact CCO Account Representative to clarify specific authorization processes for each CCO. For dates of service October 22, 2021 through March 14, 2022, work with OHA on case-by-case basis to resolve claims that should have been covered.