COVID-19 vaccine news for Oregon Health Plan members
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Provider Notices

PacificSource Health Plans and PacificSource Community Solutions Vaccine Reimbursement

3/31/2021 12:57:28 PM


Commercial - For dates of service on or after March 15, 2021, PacificSource Health Plans will utilize GPCI adjusted rates to determine allowables for COVID vaccine administration.

  • Oregon: $41.71
  • Washington: $45.41
  • Idaho: $36.59
  • Montana: $40.11

PacificSource Community Solutions (PSCS) will utilize the vaccine administration rate of $40.00 for Medicaid members (no GPCI adjustment). Prior to March 15, 2021 PSCS will reimburse based on CMS rates. Please see Oregon Medicaid COVID-19 Guide for specific Vaccine Reimbursement details. Oregon Medicaid COVID-19 Provider Guide

Note: Any claims processed with a GPCI adjustment will be reprocessed.