Under the new policy, providers are eligible to receive up to five times the typical payment when they administer COVID-19 doses to multiple Medicare beneficiaries on the same day at one location. This could mean an increase of up to $35 per vaccination.
For example, CMS said if you administer a COVID-19 vaccine on the same date to two Medicare beneficiaries in the same home, Medicare would pay $150. This includes two $40 payments for the vaccine dose and two add-on payments of $35. Previously, providers would have been reimbursed about $115 for the two beneficiaries in the same residence.
CMS said the policy will only include the add-on payment for a maximum of five vaccine administration services and only applies when fewer than 10 Medicare patients receive the vaccine.
This policy aims to increase vaccinations for at-risk patients in smaller group settings.
Earlier this year, CMS increased payments from about $40 to about $75 per vaccine dose for at-home vaccinations in certain circumstances.
“Today’s announcement aims to further boost the administration of COVID-19 vaccination — including second and third doses — in smaller group homes, assisted living facilities, and other group living situations by allowing vaccine providers to receive the increased payment,” CMS said in a news release.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
