MedicaidCoverageMedium impact
Oregon Health Plan coverage of COVID-19 testing
Oregon Health Plan·OR·Plan
Effective date
Aug 14, 2020
We identified it
Jun 20, 2026
Summary
Oregon Health Plan (Medicaid) now covers COVID-19 viral testing for all members (symptomatic or asymptomatic) when ordered by a provider, but antibody testing is only covered for hospitalized patients under 21 being evaluated for MIS-C. All tests must have FDA Emergency Use Authorization or approval.
Action Required
Immediately: Billing team must review Oregon Medicaid COVID-19 Provider Guide for specific billing codes and instructions. Ensure COVID-19 viral tests are only billed when ordered by qualified providers with FDA EUA/approved tests. Restrict antibody testing billing to hospitalized patients under 21 with MIS-C diagnosis only. Contact COVID.19@dhsoha.state.or.us for fee-for-service questions or member's CCO for managed care questions.