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Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.

Elizabeth M. Whitehorn, Director

Provider Notice issued 02/27/2026

Update Respiratory Syncytial Virus (RSV) Season

To:
 Enrolled Physicians, Advanced Practice Nurses, Nurses, Physician Assistants, Local Health Departments, Hospitals, Federally Qualified Health Centers, Rural Health Clinics, Encounter Rate Clinics, Pharmacies, and Early Intervention Services
​Date: ​February 27, 2026
​Re:
 Update Respiratory Syncytial Virus (RSV) Season

Based on current Illinois respiratory syncytial virus (RSV) data and guidance from the Illinois Department of Public Health (IDPH), RSV activity remains elevated, indicating a possible delayed end of the RSV season. The March 31, 2026, “end of season” considerations for immunization are being modified as below. 

Consistent with national trends, IDPH reports continued elevated RSV activity in Illinois, evidenced by:

  • High RSV PCR test positivity of 9.4% as of February 14, 2026 

  • Elevated emergency department visits among children ages 0–4 years

  • Elevated hospital and ICU admissions across all age groups

To protect high-risk individuals through this RSV season, the below groups will continue to be covered for RSV immunization through March 31, 2026. Any additional extension to this period will be communicated based on disease activity trends in Illinois.

  • Infants under 8 months of age born during or entering their first RSV season

  • Children 8 months through 19 months who are at increased risk of severe RSV disease and entering their second RSV season

  • Pregnant patients (available without prior authorization in pharmacy settings): 32 through 36 weeks of gestation who the clinician has determined would benefit from vaccination based on risk assessment (e.g., preference for RSV vaccination in pregnancy rather than RSV immunization for the infant or any potential barriers to receiving immunization for the infant) 

In addition, the following groups continue to be recommended and will be covered for RSV vaccination year-round if they have not previously received vaccination:

  • Adults: 50–74 years at increased risk of severe RSV disease

  • Adults: 75 years and older

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565, or the applicable MCO.

 

Laura Phelan, Administrator

Division of Medical Programs