MedicaidCoverageMedium impact
Oregon Health Plan coverage for third dose of COVID-19 vaccine
Oregon Health Plan·OR·Provider
Effective date
Aug 12, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Plan now covers third dose COVID-19 mRNA vaccines (Pfizer/Moderna) for moderately to severely immunocompromised patients when prescribed by a qualified provider. Billing should be directed to the member's CCO or OHA for non-CCO members.
Action Required
Immediately: Billing team must verify immunocompromised patients are eligible for third dose COVID-19 vaccines (Pfizer/Moderna only, not J&J) at least 28 days after second dose. Bill member's coordinated care organization (CCO) or Oregon Health Authority for non-CCO members. Non-contracted providers can bill OHA under 'no wrong door' policy. Reference Oregon Medicaid COVID-19 Provider Guide for specific billing codes and rates.