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MedicaidCoverageMedium impact

KMAP BULLETIN: Coverage of mRNA RSV Vaccine mResvia

Kansas Medicaid (KanCare)·KS · Family Medicine, Internal Medicine, Geriatrics +1 more·Medical Policy
Effective date
Jun 26, 2024
We identified it
Jun 21, 2026
Days to comply

Summary

Kansas Medicaid now covers the mRNA RSV vaccine mResvia (CPT 90683) for adults 60+ years old, reimbursing at $290.00. This coverage is retroactive to June 26, 2024, and follows ACIP recommendations for vaccination of high-risk patients.

Action Required

Action needed
Immediately: Billing team should verify Kansas Medicaid coverage for CPT 90683 (mRNA RSV vaccine mResvia) for patients 60+ years old. Update billing system to reflect $290.00 reimbursement rate. Providers should document patient age and high-risk conditions as outlined in ACIP guidelines. Submit any previously denied claims from June 26, 2024 forward for reprocessing.

Affected Billing Codes

90683