Respiratory Syncytial Virus (RSV) Vaccination: Hold Claims
On August 14, 2023, the American Medical Association (AMA) updated the CPT® Category I New Immunization Vaccine Codes Long Descriptors to include CPT codes related to RSV vaccines. At this time, rates have not yet been established for these codes. We will communicate rates to providers once they are available.
The Office of MaineCare Services (OMS) will be updating our system to include these codes and asks that all claims be held until the update is complete. If you already submitted a claim and it was denied, please wait to resubmit until we provide communication that the rates are available.
Please review the following table for more information.
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Respiratory Syncytial Virus (RSV) Vaccination Codes |
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Code |
Description |
Effective Date |
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90380 |
Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 mL dosage, for intramuscular use |
07/17/2023 |
|
90381 |
Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 mL dosage, for intramuscular use |
07/17/2023 |
|
90678 |
Respiratory syncytial virus vaccine, preF, subunit, bivalent, for intramuscular use |
05/31/2023* |
|
90679 |
Respiratory syncytial virus vaccine, preF, recombinant, subunit, adjuvanted, for intramuscular use |
05/03/2023* |
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*FDA Approval Effective Date |
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Please contact your Provider Relations Specialist with questions.
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