Medicare payments will increase from $28 to $40 for one-dose vaccines, and from $45 to $80 for two-dose vaccines, effective immediately.
In a bid to accelerate vaccinations for COVID-19, the federal government is offering Medicare providers a big bump in the reimbursements it pays for the single- and two-dose vaccinations.
The new payments -- which go into effect immediately -- will increase from $28 to $40 for one-dose vaccines, and from $45 to $80 for two-dose vaccines, increases of 43% and 78%, respectively, the Centers for Medicare & Medicaid Services announced Monday.
The exact payment rate will depend on the provider venue that administers the vaccination, and on the geographic location of the providers.
"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 said in a media release.
CMS said the higher payments will incentivize providers to increase the daily volume of vaccines they can administer, expand vaccination sites, conduct community outreach and education, and hire additional staff.
Providers receive the coronavirus vaccines for free from the federal government and cannot charge Medicare, Medicare Advantage or Medicaid patients. Most private health insurers are required to provide the vaccination to their beneficiaries with no out-of-pocket costs.
AMA Cheers
American Medical Association President Susan R. Bailey, M.D. said her group has been pushing for more money since President Joseph R. Biden took office in January.
"The additional resources will increase the number of clinicians who can administer the vaccine," she said. "This has been a trying time for physician practices, and we thank the administration for acknowledging the challenges of practicing medicine during a pandemic."
“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
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The exact payment rate will depend on the provider venue that administers the vaccination, and on the geographic location of the providers.
CMS said the higher payments will incentivize providers to increase the volume of vaccines they can administer every day, and to expand vaccination sites, conduct community outreach, and hire additional staff.