Mid-Year Preventive Schedule Update: MEB Screening and RSV Vaccine

Effective immediately (June 25, 2026): (1) Billing team must update billing system to recognize MEB Screening and RSV Vaccine as covered preventive services under the 2026 Preventive Schedule with zero cost-sharing for applicable members. (2) Verify and add appropriate CPT/HCPCS codes for MEB screening (typically 96160 or similar behavioral health screening codes) and RSV vaccine administration (typically 90756 or similar) to fee schedules and claim processing rules. (3) Providers must update clinical documentation templates to identify eligible members for MEB Screening (age birth-21, once yearly) and RSV Vaccine (age 50+). (4) Front desk and eligibility staff should flag members aged 50+ and pediatric patients (birth-21) for these preventive services at check-in. (5) Review and update prior authorization protocols if applicable—these are preventive services and should not require prior auth. (6) Communicate updates to all clinical and billing staff via staff meeting or memo. Failure to implement may result in incorrect billing (e.g., applying cost-sharing when none should apply) and patient complaints.