CMS to pay $40 for booster dose of Covid-19 vaccine

August 18, 2021

Last week, CMS announced Medicare will pay $40 for administering a booster dose of the Pfizer or Moderna Covid-19 vaccine to certain immunocompromised individuals, in accordance with the new FDA Emergency Use Authorization (EUA).

Effective Aug. 12, 2021, CMS will pay for the administration of additional doses of Covid-19 vaccines, using CPT code 0003A for the Pfizer vaccine and CPT code 0013A for the Moderna vaccine. The payment rate of about $40 matches what CMS is reimbursing providers for initial doses.

All claims with these codes will be held until CMS completes claims system updates to allow for processing. The agency said this is expected to be completed by no later than August 27.

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