2024 Mid-Year Preventive Schedule

The following updates were made to the 2024 Preventive Schedule:

  • Hepatitis C Screening for Infants – The Centers for Disease Control and Prevention (CDC) now recommends hepatitis C screening for infants exposed to hepatitis C through their mother during pregnancy. This is a benefit expansion.

  • Over-the-Counter (OTC) Drugs – For covered OTC drugs and supplies, they must be purchased through in-network pharmacies at the pharmacy counter and not the retail counter.

  • Respiratory Syncytial Virus (RSV) Vaccines – The CDC recommends the RSV vaccine for:
    • Children who are 2 and younger
    • Pregnant women
    • Adults aged 60 and older

    NOTE: These were already benefits for Highmark members.

  • New Drug Recommended for Preexposure Prophylaxis for HIV – Update includes injectable Apretude (procedure code J0739) to pay with no cost share. Previous recommendation included oral medication only.

To access the updated Preventive Health Guidelines, go to the Provider Resource Center, select EDUCATION/MANUALS from the left menu and click Preventive Health Guidelines.