MedicaidCoverageMedium impact
KMAP BULLETIN: Coverage of Respiratory Syncytial Virus (RSV) Vaccines – Age Expansion
Kansas Medicaid (KanCare)·KS · Family Medicine, Internal Medicine, General Practice +1 more·Medical Policy
Effective date
Jun 25, 2025
We identified it
Jun 21, 2026
Summary
KMAP (Kansas Medicaid) has expanded RSV vaccine coverage to include adults aged 50-59 years at increased risk of severe RSV, effective June 25, 2025. Three RSV vaccines (Abrysvo, Arexvy, mResvia) are now covered for this age group with specific reimbursement rates.
Action Required
Before June 25, 2025: Billing team must update system to recognize RSV vaccine coverage (CPT 90678, 90679, 90683) for Kansas Medicaid members aged 50-59 at increased risk. Update encounter forms and verify patient age and risk factors per CDC guidelines. Set reimbursement rates: Abrysvo $295, Arexvy $280, mResvia $290.