MedicaidReimbursementMedium impact
Respiratory Syncytial Virus (RSV) Vaccine/Monoclonal Procedures Rate Update
Arkansas Medicaid·AR · Pediatrics, Allergy & Immunology, Infectious Disease +2 more·Coding
Effective date
Jul 1, 2026
We identified it
Jun 26, 2026
Summary
Arkansas Department of Human Services has updated the reimbursement rate for RSV vaccine and monoclonal antibody administration procedures for children to $19.54 per unit, effective July 1, 2026. Billing teams must update fee schedules and rate tables in their billing systems to reflect this new flat rate across all four RSV procedure codes.
Action Required
By June 30, 2026: Billing team must update the fee schedule in the billing system to reflect the new $19.54 reimbursement rate for CPT codes 90380, 90381, 90382, and 90678 when billed with modifiers EP, TJ, or SL. Verify that claims submitted on or after July 1, 2026 are priced at the updated rate. Test billing scenarios to ensure the system applies the correct rate. Failure to update rates may result in underpayment or claim processing delays.