Centers for Medicare and Medicaid Services (CMS) Expands Medicare Payments for At-home COVID-19 Vaccinations
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Sep
07
Centers for Medicare and Medicaid Services (CMS) Expands Medicare Payments for At-home COVID-19 Vaccinations
CMS is expanding opportunities for Medicare beneficiaries to receive COVID-19 vaccinations at home. Health care providers can now receive additional payments for administering vaccines to multiple residents in one home setting or communal setting of a home.
Vaccine providers will receive the increased payment up to five times when fewer than 10 Medicare beneficiaries get the vaccine on the same day in the same home or communal setting. This policy will help ensure at-risk patients in smaller settings have the same opportunities as others to receive the vaccination.
While many Medicare beneficiaries are able to receive a COVID-19 vaccine at a retail pharmacy or from a health care provider, some people have great difficulty leaving their homes or cannot easily access vaccination in these settings. These individuals are often at-risk patients who could require complex care if they contract COVID-19 and need to be hospitalized. To better serve this group, Medicare previously increased the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose, in certain circumstances.
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, is geographically adjusted based on where the service is furnished.
Vaccine providers will receive the increased payment up to five times when fewer than 10 Medicare beneficiaries get the vaccine on the same day in the same home or communal setting. This policy will help ensure at-risk patients in smaller settings have the same opportunities as others to receive the vaccination.
While many Medicare beneficiaries are able to receive a COVID-19 vaccine at a retail pharmacy or from a health care provider, some people have great difficulty leaving their homes or cannot easily access vaccination in these settings. These individuals are often at-risk patients who could require complex care if they contract COVID-19 and need to be hospitalized. To better serve this group, Medicare previously increased the total payment amount for at-home vaccination from approximately $40 to approximately $75 per vaccine dose, in certain circumstances.
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, is geographically adjusted based on where the service is furnished.
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