Medicare nearly doubles payment for at-home Covid-19 vaccinations

June 11, 2021

In an effort to get more Covid-19 vaccinations into the arms of the general public, the Biden Administration announced Wednesday that Medicare payments for in-home vaccinations will be nearly doubled from the current rate.

Medicare will now pay providers $75 per vaccine dose when administered at a patient’s home, up from the previous $40 rate. Administering a two-dose vaccine will pay $150 total, nearly doubling the current rate.

In explaining the move, CMS notes there are nearly 1.6 millions adults 65 or older who may have trouble accessing vaccines due to difficulty leaving their homes.

“CMS is committed to meeting the unique needs of Medicare consumers and their communities – particularly those who are home bound or who have trouble getting to a vaccination site. That’s why we’re acting today to expand the availability of the Covid-19 vaccine to people with Medicare at home,” said CMS Administrator Chiquita Brooks-Lasure in a press release announcing the move.

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.

As a reminder, Covid vaccines must be provided without cost sharing or administration fees for the patient. Providers may submit reimbursement claims for administering vaccines to uninsured individuals through the HRSA Uninsured Patient Portal.

A separate program, the HRSA COVID-19 Coverage Assistance Fund, is available to reimburse providers for vaccine administration to underinsured individuals whose health plan either does not include Covid-19 vaccination as a covered benefit, or requires cost-sharing for vaccine administration.

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