MedicaidCoverageMedium impact
OHP coverage of pharmacist-administered monoclonal antibody treatment effective September 1, 2021
Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +1 more·Provider
Effective date
Sep 1, 2021
We identified it
Jun 20, 2026
Summary
Effective September 1, 2021, Oregon Health Plan (OHP) will reimburse enrolled pharmacists for subcutaneous administration of COVID-19 monoclonal antibody treatment (REGEN-COV) in various settings. Billing is only for administration services, not the drug product itself, which is provided at no cost through federal allocation.
Action Required
Immediately: Billing team must review the OHA's Oregon Medicaid COVID-19 Provider Guide at bit.ly/OHP-COVID-Guide for current billing codes and rates for mAb administration. When billing OHP for REGEN-COV treatment, only bill for administration services (not the drug product) and bill the member's coordinated care organization (CCO) or Oregon Health Authority for non-CCO members. Update billing procedures to ensure drug product is never billed as it's provided at no cost through federal allocation.