Medicare Payment for COVID-19 Vaccination Increased

Medicare Payment for COVID-19 Vaccination Increased

On March 15, the Centers for Medicare & Medicaid Services (CMS) is increasing the Medicare payment amount for administering the COVID-19 vaccine.

“This new and higher payment rate will support important actions taken by providers that are designed to increase the number of vaccines they can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff.

At a time when vaccine supply is growing, CMS is supporting provider efforts to expand capacity and ensure that all Americans can be vaccinated against COVID-19 as soon as possible,” – CMS said.

US COVID-19 Vaccination Progress

The Centers for Disease Control and Prevention (CDC) said on Sunday about 81.4 million people have received at least one dose of a Covid-19 vaccine, including about 44.1 million people who have been fully vaccinated by Johnson & Johnson’s single-dose vaccine or the two-dose series made by Pfizer-BioNTech and Moderna.

The work to distribute the vaccine comes as more than 541,000 people in the United States have died after contracting the virus. Providers are administering about 2.49 million doses per day on average. President Biden promised to administer 100 million vaccines by his 100th day in office and the United States surpassed that goal on March 19, his 59th day.

“He also set a goal earlier this year for the country to administer more than 1.5 million doses a day, despite criticism that it was not ambitious enough. Mr. Biden has since suggested that the U.S. may reach a point in the future where providers can administer an average of five million doses a day,” – The New York Times writes.

Medicare Payment Rate for COVID-19 Increase

Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine.

This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished. 

These updates to the Medicare payment rate for COVID-19 vaccine administration reflect new information about the costs involved in administering the vaccine for different types of providers and suppliers, and the additional resources necessary to ensure the vaccine is administered safely and appropriately.

“CMS is updating the set of toolkits for providers, states and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine,” – the company reported.

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