Covid Vaccine Shot Reimbursement Increased

Covid-19 vaccine shot reimbursement rates have been increased by CMS.

For COVID-19 vaccines administered on or after March 15, 2021, and for additional doses of the COVID-19 vaccine administered on or after August 12, 2021, the Medicare payment rates for administering the vaccines are:
• Approximately $40 for single-dose vaccines
• For vaccines requiring multiple doses, approximately $40 for each dose in the series, including any additional doses

According to CMS, “These rates reflect updated information about the costs involved in administering the COVID-19 vaccine for different types of providers and suppliers and the additional resources you need to safely and appropriately administer the vaccine.”

For comparison, Medicare payment rates for vaccines administered before March 15 are:
• $28.39 for single-dose vaccines
• For vaccines requiring a series of 2 or more doses
o $16.94 for the initial dose(s) in the series
o $28.39 for the final dose in the series

Important note: CMS geographically adjusts the above rates based on where you administer the vaccine.

Additional payment for home-administered vaccine

Medicare’s additional payment amount for administering the COVID-19 vaccine in the home for certain Medicare patients is $35 per dose. This is in addition to the standard administration amount shown above, for a total of approximately $75.

Providers do not have to certify that the patient is homebound, but they must document in the patient’s medical record their clinical status or the barriers they face to getting the vaccine outside the home.

 

Resources
Medicare COVID-19 Vaccine Shot Payment
FDA Covid Booster Announcement

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