BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan cover Synagis (palivizumab) according to the Respiratory Syncytial Virus (RSV) prophylaxis guidelines the American Academy of Pediatrics (AAP) Committee on Infectious Diseases wrote and published in the AAP Red Book®. We want to clarify our coverage policy for the upcoming RSV season.
Please note that coverage will be available beginning October 15, 2010 and extending through March 31, 2011. Service requests may be made prior to the available coverage date, but the request must be for dates of service during the coverage period. We will deny any claims filed for dates of service between April 1, 2010 and October 14, 2010.
Click here for additional prior authorization and precertification information for Synagis.