MedicaidBilling CodesMedium impact
FQHC/RHC Reimbursement for COVID-19 Vaccine Administration
Oregon Health Plan·OR · Family Medicine, Internal Medicine, General Practice +1 more·Provider
Effective date
Mar 12, 2021
We identified it
Jun 20, 2026
Summary
Oregon Health Authority will now reimburse FQHCs and RHCs for COVID-19 vaccine administration at the clinic's Medicaid PPS encounter rate. New specific billing codes are provided for Pfizer, Moderna, and Johnson & Johnson vaccines with different billing procedures for CCO members versus fee-for-service members.
Action Required
Immediately: FQHCs and RHCs in Oregon must update billing systems to use the new COVID-19 vaccine administration codes (0001A, 0002A, 0011A, 0012A, 0031A). For fee-for-service members, add U1 modifier when COVID-19 vaccine is administered during primary care visits to ensure PPS rate payment instead of zero pay. Bill CCO members as usual through their respective CCOs.