CMS increases Medicare payment amount for administering COVID-19 vaccines

The Centers for Medicare & Medicaid Services said March 15 it is increasing the Medicare payment amount for administering the COVID-19 vaccine, effective for vaccines administered on or after March 15.

According to CMS, the national average payment rate will increase from $28 to $40 for single-dose vaccines and approximately $45 to $80 for two-dose vaccines. The exact payment rate will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished, the agency said in a news release.

CMS also said the increased payment rate is aimed at expanding the number of vaccines providers can furnish each day, including establishing new or growing existing vaccination sites, conducting patient outreach and education, and hiring additional staff.

In the news release, CMS said that state Medicaid and CHIP agencies must provide vaccine administration with no cost sharing for nearly all beneficiaries during the public health emergency and at least one year after it ends. CMS and the Departments of Labor and Treasury are also requiring that most private health plans and issuers cover the COVID-19 vaccine and its administration, both in-network and out-of-network, with no cost sharing during the pandemic. For individuals who are uninsured, CMS said providers may submit claims for reimbursement through the Provider Relief Fund, administered by the Health Resources and Services Administration.

For more information on Medicare payments for COVID-19 vaccine administration, including a list of billing codes, payment allowances and effective dates, visit CMS.gov.