All PlansCoverageMedium impact
Flu, RSV, and COVID-19 vaccine recommendations: Fall and winter 2023–2024
UPMC Health Plan·Family Medicine, Internal Medicine, Pediatrics +1 more·Reimbursement
We identified it
Jun 20, 2026
Summary
UPMC Health Plan updated vaccine recommendations for fall/winter 2023-2024 covering flu, COVID-19, and RSV vaccines based on CDC guidelines. The policy clarifies age-specific dosing for COVID-19 and RSV vaccines, including new RSV vaccines for adults 60+ and pregnant patients, plus pediatric RSV prevention with Beyfortus.
Action Required
Immediately: Review current vaccine billing procedures to ensure compliance with CDC ACIP recommendations for flu, COVID-19, and RSV vaccines. Verify in-network pharmacy participation for vaccine administration. Update patient education materials to reflect new RSV vaccine availability for adults 60+ and pregnant patients 32-36 weeks. Billing team should confirm member cost-sharing applies when using out-of-network providers or non-ACIP recommended usage.