10/02/2023
The Texas Pediatric Society’s Respiratory Syncytial Virus (RSV) task force detected a trend of positive tests for the RSV in lower south Texas. As a result, on October 2, 2023, the Texas Health and Human Services Commission (HHSC) will start the 2023- 2024 monthly prophylaxis for RSV for all counties in state health service region 11.
Please note the following important information:
- Please check the 2023-2024 RSV Season Schedule for public health regions in Texas.
- Other regions will not be opened at this time. HHSC will continue working with the Texas Pediatric Society’s task force to determine additional information such as the RSV prophylaxis schedule for other regions.
- Prescribing providers must prescribe Synagis to infants meeting the criteria described on the American Academy of Pediatrics website. The 2022-2023 season criteria did not change.
- The option to purchase and bill through Texas Medicaid and Healthcare Partnership (TMHP) is not available this season.
Prior Authorization Forms
Blue Cross and Blue Shield of Texas (BCBSTX) authorization forms are located on our Utilization Management page. Below are the 2 required documents to submit for processing.
- Texas Standard Prior Authorization Request Form for Health Care Services
- Synagis Standard Prior Authorization Addendum (HHS Form 1321)
Providers, for questions or additional information, please:
- Contact your Medicaid Provider Network Representative at 1-855-212-1615.
- Submit via email Texas Medicaid Network Department.