The Centers for Medicare & Medicaid Services (CMS) will increase the reimbursement for at-home COVID-19 vaccines by $35 per vaccination when the shots are administered to multiple residents in one home or communal home setting. This new amount is on top of the earlier increase in June for vaccines administered in a beneficiary’s home.
For the administration of a dose of a COVID-19 vaccine to two beneficiaries in the same home on the same day, Medicare would pay approximately $150 ($40 for each COVID-19 vaccine dose, the $35 rate for the in-home vaccine administration, plus the additional payment of $35). Providers can get the enhanced rate up to five times when fewer than 10 beneficiaries get the vaccine on the same day and in the same setting.
The additional payment is meant to help address the costs and challenges providers face with administering the vaccine in a beneficiary’s home and to increase the administration of COVID-19 vaccines for access-challenged and hard-to-reach individuals in smaller group homes, assisted living facilities, and other group living arrangements.
Additional information is available on the Medicare COVID-19 Vaccine Shot Payment page.