Coverage of Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) for Measles Post-Exposure Prophylaxis in Medicare Advantage Members

By January 16, 2026: Billing team must update billing system configuration to recognize IVIG and SCIG as covered services for measles post-exposure prophylaxis under Medicare Advantage plans. Ensure claims are submitted with appropriate diagnosis code Z20.8 (exposure to communicable disease—measles) or related measles exposure codes. Verify that prior authorization requirements (if any) are documented in the MA plan rules and implement into workflow. Update claim templates and provider education materials to reflect this coverage. Verify that claims for IVIG/SCIG with measles post-exposure indication are processed without automatic denial. Confirm with the MA plan whether prior authorization is required before administration.