MedicaidBilling CodesMedium impact
OHP pharmacies can now bill COVID-19 vaccine administrations through point of sale
Oregon Health Plan·OR·Provider
We identified it
Jun 20, 2026
Summary
OHP pharmacies can now bill COVID-19 vaccine administrations through point-of-sale systems effective immediately. Only administration fees can be billed (not the vaccine itself), with specific reimbursement amounts for first dose ($16.94), second dose ($28.39), and single dose ($28.39).
Action Required
Immediately: OHP-contracted pharmacies must update point-of-sale billing systems to bill COVID-19 vaccine administration only (not serum). Configure systems with specific NCPDP field values: Professional Service Code MA, Service Clarification Code 2 for first dose/6 for second dose, and Incentive Amounts $16.94/$28.39/$28.39. Ensure same manufacturer NDC codes for two-dose series or contact Oregon Pharmacy Call Center at 888-202-2126 for prior authorization if different manufacturers used.