CMS increases payment rate for COVID-19 vaccine administration

March 16, 2021

The Centers for Medicare & Medicaid Services (CMS) increased the Medicare payment amount for administering COVID-19 vaccines, according to a news release from the agency.

Effective for COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies, and many other immunizers will be $40 to administer each dose of a COVID-19 vaccine, CMS said. This represents an increase of approximately $28 to $40 for the administration of single-dose vaccines, and an increase of approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses.

The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished, CMS said.

The agency also said it updated the payment rate based on “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 also said it is updating a set of toolkits for providers, states and insurers to help the healthcare system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries,

CMS reiterated that no beneficiary – whether covered by private insurance, Medicare or Medicaid – should pay cost-sharing for the administration of the COVID-19 vaccine.

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