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2024-2025 RSV and Synagis Season Prior Authorization

Date: 10/17/24

Effective October 1, 2024, the Texas Health and Human Services Commission (HHSC) opened the 2024 – 2025 monthly prophylaxis for Respiratory Syncytial Virus (RSV) for regions 5 and 6. HHSC made this update as recommended by the Texas Pediatric Society's RSV task force.

HHSC will open the remaining RSV regions as listed below:

  • October 15, 2024: Regions 7 and 11
  • November 1, 2024: Regions 3, 4 and 8
  • November 15, 2024: Regions 1, 2, 9 and 10

Please note the following important information:

  • The 2024-25 RSV Season Schedule is broken out by Texas public health regions.
    • Please check the schedule for any additional updates throughout season.
  • Prescribing providers must prescribe Synagis® to infants that meet the criteria described on the American Academy of Pediatrics RSV Prevention webpage.
    • Criteria has been updated to include questions around Beyfortus™ administration during the current RSV season and will look for rationale to support why it cannot be administered.
  • The option to purchase and bill through Texas Medicaid & Healthcare Partnerships is not available this season.
  • HHSC will continue working with the Texas Pediatric Society's task force to monitor region testing trends and will provide additional instruction.

Superior HealthPlan's Synagis® Season – Prior Authorization Form (PDF) is listed in the Medicaid Prior Authorization Forms section of Superior’s Forms page.

For any questions, please contact Centene Pharmacy Services at 1-866-768-7147.