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Mid-Year Preventive Schedule Update: MEB Screening and RSV Vaccine
Effective date
Jun 25, 2026
Identified
Jun 26, 2026
Summary
Highmark has added two new preventive services to their 2026 Preventive Schedule effective immediately: Mental, Emotional, Behavioral (MEB) Screening for members birth to 21 years (once per year) and RSV Vaccine with a lowered recommended age from 60 to 50 for adults in the general population. Billing teams must update coding systems and provider education to ensure these services are billed with correct preventive care codes and covered without cost-sharing.
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What to do
Action · 7 steps
01Effective immediately (June 25, 2026).
02Billing 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.
03Verify 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.
04Providers must update clinical documentation templates to identify eligible members for MEB Screening (age birth-21, once yearly) and RSV Vaccine (age 50+).
05Front desk and eligibility staff should flag members aged 50+ and pediatric patients (birth-21) for these preventive services at check-in.
06Review and update prior authorization protocols if applicable—these are preventive services and should not require prior auth.
07Communicate updates to all clinical and billing staff via staff meeting or memo.
If missed: Failure to implement may result in incorrect billing (e.g., applying cost-sharing when none should apply) and patient complaints.
Original notice
Mid-Year Preventive Schedule Update: MEB Screening and RSV Vaccine
providers.highmark.com · Always check the source before changing claims.