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Discuss Flu Shots and Other Vaccines with Our Members
BCBS New Mexico·NM·General
Effective date
Aug 18, 2026
We identified it
Aug 19, 2026
Summary
Blue Cross and Blue Shield of New Mexico is encouraging providers to discuss flu, COVID-19, and other vaccines with members and has published updated adult immunization quality measures (HEDIS). This is an informational/educational guidance update with no billing code changes, prior authorization changes, or coverage modifications. Providers should use this to counsel members and close immunization care gaps.
Action Required
No immediate billing system changes required. This is educational guidance only. Recommend: (1) Providers and clinical staff review the updated Adult Immunization Status measure requirements (influenza yearly, Td/Tdap every 10 years, herpes zoster starting age 50, pneumococcal for 65+, hepatitis B ages 19-59, RSV for 75+ or high-risk 50-74). (2) Update patient counseling materials and EMR templates to address vaccine benefits, side effects, and patient concerns. (3) Verify member eligibility and benefits before administering vaccines, as cost-sharing may vary by plan. (4) Reference the Quality Care 2026 HEDIS booklet in Availity Essentials for documentation and coding guidance. (5) Encourage member participation in Turquoise Rewards for incentives. No claim processing changes or denial risk from inaction—this is clinical quality guidance.