MedicaidPrior AuthMedium impact
RSV Prophylaxis – Update #2
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Pulmonology, Infectious Disease·Provider Notice
Effective date
Aug 27, 2021
We identified it
Jun 20, 2026
Summary
Missouri Medicaid (MO HealthNet) is temporarily approving RSV prophylaxis prior authorization requests during July-September 2021 due to increased RSV cases, with up to 3 doses approved that won't count toward the regular season limit of 5 doses.
Action Required
For July-September 2021: Billing team should submit RSV prophylaxis prior authorization requests to MO HealthNet for eligible participants, noting that approved doses during this summer period will not count toward the regular 2021-2022 RSV season 5-dose limit. Contact MO HealthNet at 800-392-8030 with questions.