Stay Updated

Respiratory illinesses, like RSV (Respiratory Syncytial Virus), can have vastly different effects on infants and young children. Some may only experience cold-like symptoms. However, some babies may have more severe symptoms that can lead to hospitalization.

In 2023, two methods for protecting infants from RSV were approved by the FDA: a monoclonal antibody injection (Beyfortus) given directly to the infant, and a vaccination given to the pregnant mother before delivery. Both methods use antibodies not generated by the infant's own immune system to afford short term protection that lasts long enough to protect them during their first RSV season when they are most vulnerable.

Our practice is once again planning to offer Beyfortus and we want to share some important details for parents when considering this injection for your baby.

eligibility  & availability

• Beyfortus is available to babies younger than 8 months old who are born during, or are entering their first “RSV season” in October.
• Children aged 8 - 19 months with high risk conditions are also eligible to receive Beyfortus.
• Babies of mothers who received the RSV vaccine at least 2 weeks before delivery may not be eligible for Beyfortus. Please call the office or speak with your pediatrician at the next visit to determine eligibility for your baby.
• Though we are not aware of any supply shortages at this time, we cannot guarantee how many doses will be available, so we encourage parents to start considering now if you are interested in Beyfortus for your baby.

insurance   Information

Many insurance companies cover the cost of Beyfortus, but some plans may have different coverage. Parents should contact their individual insurance plans to determine if Beyfortus will be covered for their baby.

As we are not participants with the Vaccinces for Children (VFC) program, families who are under a Medicaid plan will need to contact the McLean County Health Department for the RSV injection.

Here are the details you will need to know when you contact your plan.

• The billing procedure (CPT) codes for Beyfortus are:
  • Beyfortus Injection: 90380
  • Beyfortus Administration: 96380
• The billing diagnosis (ICD-10) code for Beyfortus is Z29.11

The charges billed to insurance will be $1000 for the injection and $50 for the administration. If your insurance plan determines the injection is a non-covered service under your health plan, we will offer a discounted price of $600 on the injection.

Scheduling

Appointments for Beyfortus begin October 1st. You may request to have the injection given at your baby's next well visit or you may schedule a shot only appointment. If you have questions about your child receiving or eligibility for Beyfortus, or would like to schedule an appointment for the injection, you may call us at 309-662-0504 and select option 1 to speak with a pediatric nurse.