MedicaidCoverageMedium impact
OHP coverage of COVID-19 testing
Oregon Health Plan·OR·Plan
Effective date
Oct 23, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (OHP) now covers COVID-19 viral testing for both symptomatic and asymptomatic members when medically necessary and ordered by a qualified provider. Antibody testing is only covered for diagnostic workup of MIS-C/MIS-A in hospitalized patients.
Action Required
Immediately: Billing team should verify coverage for COVID-19 viral testing for all OHP and CAWEM members, both symptomatic and asymptomatic when medically necessary. Ensure antibody testing is only billed for hospitalized patients with MIS-C or MIS-A diagnostic workup. Contact Provider Services at 800-336-6016 (Option 5) for fee-for-service questions or the member's CCO for managed care questions.