RSV (Respiratory Syncytial Virus)

Your baby might be eligible for RSV monoclonal antibody shot. Most babies contract RSV by 2 years old. It can cause symptoms such as fever, cough and difficulty breathing. RSV can also cause lung infections such as pneumonia. RSV is the #1 cause of hospitalization of babies under 1 year old. RSV is spread most commonly during the months of November through March. We believe your child would benefit from this immunization.

 

Information About RSV shot

Please read the following information on RSV infection and what the RSV shot can do to help protect your baby.

Let's Talk About RSV

RSV Vaccine Information Statement

 

Cost of RSV Shot

If your child has Medicaid health insurance, this shot is free for your baby. If you have private insurance through your employer or through a private self-insured policy, may have coverage for this shot. However, some plans may not pay for the immunization. If your baby receives this shot and it is not paid for by your insurance, you will be responsible for the payment of $600 per shot.

 

Payment for RSV shot

For patients with private insurance, we will require a credit card to be kept on file until your insurance has processed the claim. Once your insurance has paid for the RSV shot, we will remove the credit card from your account. If your insurance does not pay for the RSV shot, we will charge your card on file. Please note that we will not accept Health Savings Cards (HSA cards) on file for this vaccine because most HSA plans do not have enough funds available to pay for the shot. However, we do offer the option to leave a credit card on file as a back-up and allow the parent to make a payment with their HSA card instead. Once the claim is processed, if the insurance has denied payment in part or whole, the parent will be notified via text message that they are responsible for payment and need to call in with their HSA card. The parent will be required to make a payment with their HSA card within 48 hours of notification, otherwise the credit cardon file will be charged for payment.

 

Check Insurance Coverage

You can check with your insurance to see if you have coverage for the RSV Shot. Depending on your baby’s weight, some of these codes may be billed more than once. The procedure codes (CPT codes) that may be billed for the RSV shot are:

90380 – RSV monoclonal antibody, 0.5mL dose (<5kg = 11 lbs)

90381 – RSV monoclonal antibody, 1mL dose (>5 kg = >11 lbs)

96380 – Injection of RSV antibody with counseling

 

Schedule Your Baby

If you would like your baby to receive the RSV shot, please call us today to schedule at 847-359-5000.