CMS Expands Medicare Payments For Administering In-Home COVID-19 Vaccines

CMS Expands Medicare Payments

CMS Expands Medicare Payments

In order to improve health equity and more importantly increase the COVID-19 vaccinations. The Centers for Medicare & Medicaid Services (CMS) has announced additional payments for administering in-home COVID-19 vaccines to multiple residents of the same home or communal living setting.

In this way, Medicare beneficiaries will get vaccinations jab without leaving their homes. However, healthcare providers who are providing the in-home vaccination services will get additional payments. According to the official statement issued by the federal agency. Vaccine providers will receive an increased payment up to five times after providing the vaccination services to the approximately ten Medicare beneficiaries on the same day in the same communal setting.

This initiative taken by the Biden-Harris Administration will make sure that at-risk patients, regardless of whether they belong to the smaller settings, have the same opportunities as others to receive the vaccination. Healthcare providers will get an additional reimbursement of about $35 per dose administered for up to a maximum of five vaccine administration services.

CMS Administrator Chiquita Brooks-LaSure in an official statement said that: the federal government is taking every possible move to eliminate the barriers to vaccinations. For this purpose, the concerned authorities are taking appropriate measures to ensure the maximum compensation of the vaccine providers. That will ultimately encourage them to reach the maximum number of people in their communities. Particularly those, who haven’t received the vaccine in a traditional setting.

While seeing the potential outcomes of the vaccinations, the government is inviting more healthcare providers to join this drive for a better cause. Therefore, authorities are continuously increasing the benefits including vaccination rates across the country, she further added. She made it clear that the basic purpose of this initiative is to encourage the in-home COVID-19 vaccinations to make sure that: every American i.e. older or adult, having mobility or transportation issues, get vaccinated without any issue.

The additional payments will also help healthcare providers to combat issues like ensuring appropriate vaccine storage temperatures, handling, and administration. Moreover, medical care providers will become better able to deliver COVID-19 vaccination to access-challenged and hard-to-reach individuals.

The additional amount also accounts for the upfront costs associated with delivering vaccine services safely in a beneficiary’s home. And the clinical time required to monitor the beneficiary after vaccination. Furthermore, the payment rate for each dose of vaccine & additional in-home payment amount depends on the location, where the services are provided.

How Can You Find a COVID-19 Vaccine?

In order to break down the barriers and expand access to the COVOD-19 vaccine, the federal government is taking several measures. Such as: increasing the payments for the healthcare providers and more importantly encouraging the home-based vaccines to make sure that every native has access to quality healthcare and the country stands strong against the ongoing pandemic.

However, if you are still unvaccinated of looking to help friends and family, you can:

  • Visit (English) or (Spanish) to search for vaccines nearby.
  • Text GETVAX (438829) for English or VACUNA (822862) for Spanish for near-instant access to details on three vaccine sites in the local area.
  • Call the National COVID-19 Vaccination Assistance Hotline at 1-800-232-0233 (TTY: 1-888-720-7489) for assistance in English and Spanish.

Coverage of COVID-19 Vaccines

It’s pertinent to mention here that Americans get the COVID-1 vaccine free of charge. Medical practitioners who are providing the vaccine services cannot charge patients any amount for administering the vaccine. Because no patient can be billed for COVID-19 vaccinations.

Original Medicare and Medicare Advantage

There are no applicable copayment, coinsurance or deductible for the Medicare beneficiaries.

Medicaid and the Children’s Health Insurance Program (CHIP)

During the ongoing healthcare emergency caused by the COVID-19 and after a year it ends. State Medicaid and CHIP agencies should cover the vaccine administration with no cost-sharing for nearly all beneficiaries.

However, the healthcare providers who are Medicaid beneficiaries but aren’t eligible for this coverage, have to submit the medical claims for providing the vaccination services to the underinsured individuals through the COVID-19 Coverage Assistance Fund, administered by the Health Resources and Services Administration (HRSA).

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