Medicare Compliance & Reimbursement

In another effort to boost COVID-19 vaccinations for Medicare beneficiaries, the Centers for Medicare & Medicaid Services (CMS) is offering additional payment for at-home vaccination administration.

Details: The latest policy change aims to help beneficiaries who do not have the means or ability to leave their homes to get the shot in their communities. On June 8, Medicare increased the COVID-19 administration pay for at-home vaccinations from approximately $40 to $75 per dose, which is a $35 jump in payment. “For a two-dose vaccine, this results in a total payment of approximately $150 for the administration of both doses, or approximately $70 more than the current rate,” notes a CMS release.

“CMS is committed to meeting the unique needs of Medicare consumers and their communities — particularly those who are home bound or who have trouble getting to a vaccination site. That’s why we’re acting today to expand the availability of the COVID-19 vaccine to people with Medicare at home,” said CMS Administrator Chiquita Brooks-Lasure in a release on the change.

Providers should review which types of locations are considered acceptable to receive the additional at-home vaccination payment as well as other stipulations.

Plus: The extra pay is only for COVID-19 vaccine administration; CMS will not pay the additional amount if other Medicare services are provided in the home on the same date.

“In those situations, Medicare pays for administering the COVID-19 vaccine at the standard amount (approximately $40 per dose),” agency guidance says.

See the release at www.cms.gov/newsroom/press-releases/biden-administration-continues-efforts-increase-vaccinations-bolstering-payments-home-covid-19.