MedicaidAdministrativeMedium impact
“No Wrong Door” for Oregon Health Plan providers billing for covered monoclonal antibody (mAb) services
Oregon Health Plan·OR · Infectious Disease, Emergency Medicine, Critical Care +2 more·Provider
Effective date
Sep 22, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Plan implements a 'no wrong door' policy for monoclonal antibody (mAb) billing, allowing providers not contracted with a member's CCO to bill OHA directly instead of being unable to receive payment. Providers should enroll with OHA if not already enrolled to take advantage of this simplified billing process.
Action Required
Immediately: Oregon providers treating COVID-19 with monoclonal antibodies should enroll with OHA if not already enrolled to enable direct billing when not contracted with patient's CCO. Review OHA's Oregon Medicaid COVID-19 Provider Guide for current mAb billing codes and rates. Contact local CCOs to explore direct contracting options.