MedicaidCoverageMedium impact
Update to fee-for-service COVID-19 home testing coverage effective December 1, 2021
Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +1 more·Provider
Effective date
Dec 1, 2021
We identified it
Jun 20, 2026
Summary
Effective December 1, 2021, Oregon Health Plan (Medicaid) will cover up to 4 FDA-authorized COVID-19 home testing kits per month that require internet/smartphone for interpretation, without requiring PCP order or prior authorization. More than 4 tests per month require PCP order and prior authorization as part of individualized care plan.
Action Required
By December 1, 2021: Billing team must update system to allow up to 4 COVID-19 home test kits per month for Oregon Medicaid patients without prior authorization for tests requiring internet/smartphone interpretation. For requests exceeding 4 tests monthly, ensure prior authorization is obtained through Oregon Pharmacy Call Center at 888-202-2126. Update patient counseling protocols to inform Oregon Health Plan members of new coverage limits.