CMS increase provider payment for in-home COVID-19 vaccinations

June 10, 2021

The Centers for Medicare & Medicaid Services (CMS) plans to pay an additional $35 per dose to providers for administering in-home COVID-19 vaccinations to Medicare beneficiaries who have difficulty leaving their homes or are hard to reach.

This will increase the total payment amount for in-home COVID-19 vaccinations from $40 to $75 per dose.

There are approximately 1.6 million adults 65 years old or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home., according to CMS.

Delivering COVID-19 vaccination to access-challenged and hard-to-reach individuals poses some unique challenges, such as ensuring appropriate vaccine storage temperatures, handling, and administration.

The additional payment amount also accounts for the clinical time needed to monitor a beneficiary after the vaccine is administered, as well as the upfront costs associated with administering the vaccine safely and appropriately in a beneficiary’s home. The payment rate for administering each dose of a COVID-19 vaccine, as well as the additional in-home payment amount, will be geographically adjusted based on where the service is furnished.

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