MedicaidCoverageMedium impact
Upcoming Respiratory Syncytial Viral (RSV) Season
Illinois Medicaid - HFS·IL · Pediatrics, OB-GYN, Family Medicine +1 more·Provider Notice
Effective date
Dec 31, 2025
We identified it
Jun 20, 2026
Summary
Illinois Department of Healthcare and Family Services updated RSV immunization coverage for the upcoming season, approving Beyfortus and Enflonsia for infants while discontinuing Palivizumab as of December 31, 2025. New coverage includes Abrysvo for pregnant adults during weeks 32-36 of gestation and RSV vaccines for adults 50 and older.
Action Required
By December 31, 2025: Stop billing for Palivizumab (SYNAGIS) immunizations as it will be discontinued. Update billing system to reflect coverage of Beyfortus and Enflonsia for infants, Abrysvo for pregnant women (weeks 32-36 gestation, September-January only), and Abrysvo/mResvia/Arexvy for adults 50+. Contact Bureau of Professional and Ancillary Services at 877-782-5565 for specific billing questions.