MedicaidPrior AuthMedium impact
RSV Prophylaxis - Update
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Pulmonology, Family Medicine·Provider Notice
Effective date
Aug 2, 2021
We identified it
Jun 20, 2026
Summary
Missouri Medicaid (MO HealthNet) is temporarily approving RSV prophylaxis prior authorization requests during July and August 2021 due to increased RSV cases. Approved participants will receive two doses, and these summer doses won't count toward the regular 5-dose limit for the 2021-2022 RSV season.
Action Required
Immediately: Billing team should notify providers that RSV prophylaxis prior authorization requests for July and August will be considered by MO HealthNet. Update prior auth tracking to note that summer doses (July-September) do not count toward the regular 5-dose seasonal limit. Contact MO HealthNet at 800-392-8030 with questions about RSV prophylaxis approvals.