MedicaidCoverageMedium impact
Oregon Health Plan monoclonal antibody coverage for COVID-19 treatment
Oregon Health Plan·OR · Infectious Disease, Emergency Medicine, Family Medicine +1 more·Provider
Effective date
Aug 26, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Plan now covers monoclonal antibody treatment for COVID-19 in high-risk patients, including administration services in various healthcare settings. Billing teams must only bill for drugs purchased at cost and cannot bill for federally allocated drugs received at no cost.
Action Required
Immediately: Billing team must review Oregon Medicaid COVID-19 Provider Guide for specific billing codes and rates for monoclonal antibody treatment. Only bill coordinated care organizations (CCOs) or OHA for drugs purchased at cost - do not bill for drugs obtained through federal HHS allocation at no cost. Update billing procedures to verify drug acquisition source before submitting claims.