MedicaidCoverageMedium impact
Respiratory Syncytial Virus Vaccine Code 90678 Opened for Pregnant Members Between 32 and 36 Weeks of Gestation
Nevada Medicaid·NV · OB-GYN, Family Medicine, General Practice·Provider Announcement
Effective date
Jul 30, 2024
We identified it
Jun 21, 2026
Summary
Nevada Medicaid now covers RSV vaccine (CPT 90678) for pregnant members between 32-36 weeks gestation, effective July 30, 2024. Claims previously denied with error code 753 will be automatically reprocessed, and specific ICD-10 diagnosis codes indicating weeks of gestation are required for billing.
Action Required
Immediately: Billing team must update system to allow CPT 90678 (RSV vaccine) for pregnant Nevada Medicaid members aged 32-36 weeks gestation with appropriate Z3A diagnosis codes (Z3A.32-Z3A.36). Providers who can bill physician-administered drugs should begin using this coverage. Monitor remittance advice for automatically reprocessed claims that previously denied with error code 753.