MedicaidReimbursementMedium impact
Revised Respiratory Syncytial Virus (RSV) Vaccine/Monoclonal Procedures Rate Update
Arkansas Medicaid·AR · Pediatrics, Family Medicine, General Practice +1 more·Coding
Effective date
Jul 1, 2026
We identified it
Sep 29, 2026
Summary
The Arkansas Department of Human Services updated reimbursement rates for RSV vaccine and monoclonal antibody administration procedures effective July 1, 2026. All four RSV-related CPT codes (90380, 90381, 90382, 90678) are now reimbursed at a flat rate of $19.54 per administration when billed with modifiers EP, TJ, or SL.
Action Required
By June 30, 2026: Billing team must update fee schedules in billing software to reflect the new $19.54 rate for CPT codes 90380, 90381, 90382, and 90678 when submitted with modifiers EP, TJ, or SL for Arkansas Medicaid claims. Verify that current rates differ from $19.54 and update accordingly. Effective July 1, 2026, all RSV procedure claims to Arkansas DHS must use the revised rates or claims may be denied/adjusted. Contact the Provider Assistance Center at (800) 457-4454 or (501) 376-2211 with questions.