CommercialCoverageHigh impact
Synagis ® (Palivizumab)
UnitedHealthcare·Pediatrics, Infectious Disease, Critical Care·Medical Policy
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
CRITICAL: This policy has been RETIRED as of July 1, 2026. Synagis® (Palivizumab) coverage guidance under this medical policy is no longer active. The billing team must immediately identify any active Synagis claims in process and determine the current applicable coverage policy, as this retirement may affect prior authorization, billing codes, and coverage determinations for this drug.
Action Required
IMMEDIATELY: Billing team must (1) cease using this retired Synagis policy as a reference for any coverage or billing decisions; (2) contact UHC Provider Services to obtain the current active medical policy for Synagis (Palivizumab) replacement guidance; (3) audit all pending and in-process Synagis claims to verify they are being adjudicated under current policy, not this retired version; (4) update billing system rules, clinical documentation templates, and prior authorization workflows to reference the new active policy once identified. Failure to implement current policy may result in claim denials, payment delays, and compliance issues. Complete audit and policy transition by July 15, 2026.