On Monday March 15, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that the Medicare reimbursement for administration of the COVID-19 vaccine would nearly double.
The rate will increase from approximately $28 to $40 for the administration of single-dose vaccines and from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is furnished.
As vaccine supplies are increasing advocacy by the AMA and national specialty societies worked to help ensure that you receive adequate reimbursement for administering these vaccines as a key step in ending the pandemic. The updated Medicare payment rate reflects the additional resources necessary to ensure the vaccine is administered safely and appropriately. The costs are incorporated into the new CPT code 99072 and are bundled with COVID immunization administration payments. Patients do not incur any charge for the vaccine.
CMS is updating the set of toolkits for providers, states and insurers to help the health care system swiftly administer the vaccine with these new Medicare payment rates. These resources are designed to increase the number of providers that can administer the vaccine, ensure adequate payment for administering the vaccine to Medicare beneficiaries, and make it clear that no beneficiary, whether covered by private insurance, Medicare or Medicaid, should pay cost-sharing for the administration of the COVID-19 vaccine.