CMS will pay an extra $35 per dose for at-home COVID-19 vaccinations

by: Julia Kyles, CPC Jun 9, 2021

Providers who administer the COVID-19 vaccine to patients in their homes will receive an 87% pay bump for the visits, effective June 8.

The Biden administration added “an additional $35 per dose for COVID-19 vaccine administration in a beneficiary’s home, increasing the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose,” CMS announced in a press release June 9.

Providers will receive approximately $150 to administer a two-dose vaccine. Medicare will pay $35 per dose for each eligible patient in a home who receives the vaccine and one $40 administration fee, the Medicare COVID-19 Vaccine Shot Payment webpage explains.

While the vax-at-home program isn’t available to all Medicare beneficiaries, a patient does not need to be homebound – as defined by Medicare – to be eligible. For example, a patient who can’t afford to travel to a pharmacy to receive the vaccine would qualify.

The provider should “document in the patient’s medical record their clinical status or the barriers they face to getting the vaccine outside the home,” according to the COVID-19 vaccine web page.

The extra revenue will help compensate providers for the extra observation time involved in administering the vaccine and the challenges involved with getting the vaccine to patients, which include “ensuring appropriate vaccine storage temperatures, handling and administration,” the press release states.

Blog Tags: CMS, COVID-19

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