MedicaidPrior AuthMedium impact
RSV Prophylaxis
Missouri Medicaid (MO HealthNet)·MO · Pediatrics, Family Medicine, Internal Medicine +1 more·Provider Notice
Effective date
Jul 7, 2021
We identified it
Jun 20, 2026
Summary
MO HealthNet Division is temporarily approving RSV prophylaxis prior authorization requests during July 2021 due to increased RSV positivity in Missouri. Participants meeting clinical requirements will be approved for two doses, with additional doses evaluated monthly based on RSV virology data.
Action Required
During July 2021: Billing team should submit RSV prophylaxis prior authorization requests for eligible MO HealthNet participants. Approvals will include two doses automatically. For questions about eligibility or additional doses beyond two, call MO HealthNet at 800-392-8030.