CMS raises payment for COVID-19 vaccine administration

The Centers for Medicare and Medicaid Services (CMS) has announced it will increase the payment rate for the administration of COVID-19 vaccines. As of March 15, the national average payment will be $40 for each dose of a COVID-19 vaccine. That means the average payment will go from approximately $28 to $40 for administration of a single-dose vaccine, and $45 to $80 total for administration of both doses of a two-dose vaccine.

Actual payment rates will vary geographically. Check with the local Medicare Administrative Contractor for the rate in your region.

The increase, which the American Academy of Family Physicians (AAFP) and other groups advocated for, reflects the additional resources and work required to safely store and administer the vaccines.

Practices should update the allowable charges for the COVID-19 vaccine administration codes in their billing systems to ensure they receive the increased payment rate.

Additional information is available here:

• Medicare COVID-19 Vaccine Shot Payment
• CDC COVID-19 Vaccination Program Provider Requirements and Support
• HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured
• AMA Find Your COVID-19 Vaccine CPT Codes

Medicare is also in the process of updating its toolkits.

— Erin Solis, Manager for Practice and Payment at the AAFP