CommercialBilling CodesMedium impact
Review the Latest COVID-19 and RSV Billing Guidance
CareFirst BlueCross BlueShield·Family Medicine, Internal Medicine, Pediatrics·Reimbursement
Effective date
Sep 11, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield updated COVID-19 and RSV vaccination billing guidance. Monovalent mRNA COVID vaccines should be used going forward, with bivalent vaccine codes being denied for dates of service on or after September 11. RSV vaccines are covered for members with specific guidance for hospitals and pharmacies.
Action Required
Immediately: Stop billing bivalent COVID vaccine codes for dates of service on or after September 11, 2023. Use only monovalent mRNA COVID vaccine codes going forward (Novavax remains active). Billing team must verify RSV vaccine coverage under both medical AND pharmacy benefits before determining coverage. Update billing system to deny bivalent COVID codes for recent dates of service.